老年复发性小肝癌患者行再切除术与经皮射频消融术的疗效分析

目的 探讨再次手术切除与经皮射频消融在老年复发性小肝癌患者中的临床疗效。方法 回顾性分析2008 年1 月至2014 年1 月淮安第一医院收治的56 例肝癌术后以小肝癌形式复发的老年患者。其中再次手术切除治疗34例（手术切除组），经皮射频消融治疗22例（射频消融组）。比较两组的一般情况、术后生化指标、并发症发生情况以及生存状况，使用SPSS 20.0 统计学软件进行分析。结果 射频消融组患者治疗后TBIL、ALT、AST、ALB指标优于手术切除组（P＜0.05）；手术切除组患者并发症发生数（31例次）明显高于射频消融组（8 例次）（ P＜0.05）。射频消融组术后1、3、5 年无瘤生存率（86.4%、54.5%、45.5%）均明显好于手术切除组（61.8%、26.5%、14.7%），差异均有统计学意义（P＜0.05）。结论 经皮射频消融对老年复发性小肝癌患者的远期治疗效果优于手术再切除，而且射频消融具有创伤小、肝功能影响小、术后并发症低等优点。

Clinical analysis of reoperation vs percutaneous radiofrequency ablation in treatment of elderly patients with recurrent small hepatocellular carcinoma

Objective To investigate the efficacy of reoperation vs percutaneous radiofrequency ablation in elderly patients with recurrent small hepatocellular carcinoma. Methods A retrospective analysis was conducted on 56 elderly patients with recurrence of small hepatocellular carcinoma in the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University from Jan. 2008 to Jan. 2014. Among 56 patients, 34 underwent surgical resection (surgical resection group) and 22 underwent percutaneous radiofrequency ablation (radiofrequency ablation group). The general conditions, postoperative biochemical indicators, complications, and survival status were compared between the two groups, and SPSS 20.0 statistical software was used to analyze the data. Results After treatment the indexes of TBIL, ALT, AST, and ALB in the radiofrequency ablation group were better than those in the surgical resection group after (P<0.05). The number of complications in the surgical resection group (31 events) was significantly higher than that in the radiofrequency ablation group (8 events) (P<0.05). In addition, the 1-, 3-, 5-year tumor-free survival rate (86.4%, 54.5%, 45.5%) in the radiofrequency ablation group were better than those in the surgical resection group (61.8%, 26.5%, 14.7%). The differences were statistically significant (P<0.05). Conclusion Percutaneous radiofrequency ablation performs better than surgical resection in the longterm efficacy on elderly patients with recurrent small hepatocellular carcinoma. What’s more, radiofrequency ablation has the advantages of less trauma, less effect on liver function, and less postoperative complications.