经皮射频消融治疗肝脏巨大血管瘤疗效观察

摘 要] 目的 观察经皮射频消融术（PRFA）治疗肝脏巨大血管瘤（5 cm≤直径≤15 cm）的安全性及可行性。方法 回顾性分析2014年6月至2017年6月于达州市中心医院行手术治疗的78例肝巨大血管瘤患者的病例资料，其中42例行PRFA治疗（A组），36例行传统开放手术治疗（B组），通过比较手术时间、术中出血量、住院时间、住院费用、术后临床治愈率等指标，评价两种方案的疗效，观察两组患者在治疗过程中出现的不良反应或并发症，评估治疗安全性。结果 所有患者在治疗过程中均未发生严重的并发症，无一例死亡。两组术后1个月、6个月临床治愈率、术后并发症发生率无统计学差异（P > 0.05）；但两组在手术时间、术中出血量、住院时间、住院费用上存在差异，且具有统计学意义（P < 0.05）。结论 PRFA和传统开放手术治疗肝巨大血管瘤疗效相当，均具有较好的安全性；经皮射频消融术治疗肝巨大血管瘤具有微创、痛苦小、出血量少、手术时间短、住院费用低的优点。严格掌握手术适应证，选择个体化治疗方式，PRFA可为肝巨大血管瘤患者的治疗提供一种替代选择途径。

Curative effect of percutaneous radiofrequency ablation for the treatment of giant hepatic hemangiomas#br#

Abstractobjective To explore the safety and feasibility of the percutaneous radiofrequency ablation (PRFA) for the treatment of the giant hepatic hemangioma (5 cm ≤ d ≤ 15 cm). Methods A retrospective analysis was carried out in 78 patients with the giant hepatic hemangioma from Dazhou Central Hospital between Jun. 2014 to Jun. 2017. Among them, 42 patients received PRFA treatment (group A), and other 36 patients received conventional open hepatectomy (group B). The efficacy of the two schemes was evaluated by comparing the operation time, intraoperative blood loss, hospitalization duration, hospitalization cost and the postoperative clinical cure rate. The treatment safety was evaluated by observing the adverse reactions or complications occurred during the treatment. Results No patient had serious complications during the treatment, and no patient died. There were no statistical differences between group A and B about the postoperative complication, clinical amelioration rate at 1 month and 6 months after treatment (P>0.05). But there were statistical differences between group A and B on the operation time, intraoperative blood loss, hospitalization duration and hospitalization expense (P<0.05). Conclusion PRFA under the guidance of ultrasound for the treatment of giant hepatic hemangioma has obvious advantages of minimally invasive, little trauma, less blood loss, shorter operation time and lower hospitalization cost. If the surgical indications are strictly controlled, PRFA may be an alternative treatment for patients with giant hepatic hemangioma.