二次切除手术与经皮射频消融治疗切除术后复发性肝细胞肝癌的临床疗效

目的探讨二次手术切除和经皮射频消融方法治疗肝细胞肝癌患者复发病例的临床疗效和生存状况。 方法回顾性分析2011年1月至2013年5月期间58例原发性肝细胞肝癌患者资料，其中二次手术切除的患者25例(二次切除手术组)、射频消融治疗的患者33例(RFA组)。采用统计软件SPSSl8.0分析，两组生化指标等计量资料的比较使用独立t检验，两组并发症发生情况情况、生存状况计数资料的比较使用χ²检验，检验水准取0.05，双侧概率。 结果两组患者治疗后TBIL、ALT、ALB、GGT指标RFA组均好于二次手术切除组(P<0.05)；二次切除手术组患者并发症总的发生例次(34例次)明显高于RFA组(10例次)患者(P<0.05)。RFA组术后1年复发转移率(9.1%)和术后3年无瘤生存率(84.8%)均明显优于二次切除手术组(28.0%、56.0%)，差异均有统计学意义(P<0.05)。 结论经皮射频消融技术对肝细胞肝癌患者术后复发的治疗效果优于二次手术切除，患者有更好的肝功能、肿瘤复发转移发生情况及长期无瘤生存率。

Clinical observation of reoperation or percutaneous radiofrequency ablation in the treatment of patients with recurrent hepatocellular carcinoma

ObjectiveTo investigate the clinical efficacy and survival of patients with recurrent hepatocellular carcinoma underwent reoperation or percutaneous radiofrequency ablation(PRFA). MethodsRetrospective analysis were performed in 58 patients with recurrent hepatocellular carcinoma from January 2011 to May 2013, among whom 25 patients underwent reoperation, while 33 patients received PRFA Statistical analysis were performed by using SPSS18.0 software. Measurement data, such as biochemical indicators, were expressed as ±s, and were examined by using t test. Count data such as postoperative complications and survival were examined by chi square test. A P value <0.05 was considered as statistically significant difference. ResultsThere were statistically significant differences in terms of TBIL, ALT, ALB and GGT between 2 groups(P<0.05) and better outcome were achieved in PRFA group. In terms of postoperative complications, better outcome were achieved in PRFA group (10cases) compared with reoperation group (34 cases), with statistically significant difference (P<0.05). The recurrence rate of 9.1% and disease-free survival rate of 84.8% in PRFA group were significantly better than 28.0% and 56.0% in reoperation group respectively, with statistically significant difference (P<0.05). ConclusionsCompared with reoperation, better clinical outcome could be achieved by PRFA treatment for patients with recurrent hepatocellular carcinoma, including better preservation of liver function and lower tumor recurrence rate and longer disease-free survival.