腹腔镜下射频消融治疗肝癌破裂出血的临床研究

目的:探讨腹腔镜下射频消融(LRFA)治疗原发性肝癌破裂出血的临床价值.方法:选取我院2007年7月-2011年7月确诊为肝癌破裂出血患者49例,其中男30例,女19例；年龄45 ～ 76岁,中位年龄(56.0±5.1)岁；LRFA治疗组(LRFA组)16例,手术切除治疗组(对照组)33例；统计分析两组患者性别、年龄、术前肝功能分级、术中肝门阻断时间、术中出血量、手术时间、止血成功率、术后并发症发生率、再出血率的差异、生存时间及生存率的差异,检验LRFA临床效果.结果:两组患者在性别、年龄、术前肝功能分级、肿瘤大小、数目方面的差异无统计学意义(P＞0.05)；而两组患者在肝门阻断时间、术中出血量、手术时间、止血情况、再出血情况、术后并发症发生率及术后1年生存率差异有统计学意义(P＜0.05).结论:LRFA是肝癌破裂出血安全、可靠、有效的治疗手段,或可成为急诊肝癌破裂出血的首选方法.

Clinical application of laparoscopic radio frequency ablation to treat Primary liver cancer rupture

Objective： To investigate the clinical value of Laparoscopic radio frequency ablation （LRFA） to treat Primary liver cancer rupture. Methods： Select our department from July 2007 to July 2011 the diagnosis of 49 cases of liver cancer rupture bleeding in patients, 30 males and 19 females; aged 45 to 76 years, median age（56.0 ± 5.1） years, LRFA treatment group（case group） 16 cases, surgery for the treatment group （control group） 34 cases, Statistical analysis of the two groups in sex, age, preoperative liver function, Intraoperative portal triad clamping time, blood loss, operative time, hemostasis success rate, postoperative complications, the incidence rate of re-bleeding, the survival time and survival rate for testing LRFA clinical effects. Results： The two groups in gender, age, preoperative liver function grade, tumor size, the terms of the number was no significant difference（P〉0.05）. The two groups of patients in the hepatic portal clamp time, in- traoperative blood loss, operative time, hemostasis rate, rebleeding rate, incidence of postopera- tive complications index differences and survial rate for one-year were statistically significant （P〈0.05）. Conclusion： LRFA may become the more safe, reliable and effective treatments on emergency liver rupture.