中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
Chinese Journal of General Surgery
2015年
8期
631-634
,共4页
张立洪%张传永%戴新征%郝保兵%张峰
張立洪%張傳永%戴新徵%郝保兵%張峰
장립홍%장전영%대신정%학보병%장봉
癌,肝细胞%肝切除术%复发
癌,肝細胞%肝切除術%複髮
암,간세포%간절제술%복발
Carcinoma,hepatocellular%Hepatectomy%Recurrence
目的 比较经腹微波消融与再手术切除治疗复发性小肝癌(单个癌结节最大直径不超过3 cm;多个癌结节数目不超过2个,其最大直径总和＜3 cm)的疗效.方法 回顾性分析2007年1月至2010年12月收治的75例复发性小肝癌患者的临床资料,其中34例患者行经腹微波消融(微波组),41例行肿瘤再手术切除(手术切除组).比较两组患者手术情况、AFP值变化、并发症发生率、住院时间及总生存率和无瘤生存率.结果 两组肿瘤均完全清除;AFP均于3个月内恢复正常.微波组平均手术时间短于手术组[(91±33) min比(156 ±51)min,t=-6.399 5,P=0.000];微波组术中出血量少于手术组[(87±62)ml比(254±134)ml,t=-6.691 5,P=0.000];微波组平均住院时间短于手术组[(7.5±2.2)d比(11.3±2.7)d,t=-6.588 8,P=0.000].微波组和手术切除组并发症发生率分别为2.9％(1/34)和22.0％ (9/41),差异有统计学意义(x2 =5.8127,P=0.016).微波组和手术切除组1、3和5年总生存率分别为88.1％、68.8％、46.1％和86.1％、71.5％、50.2％(x2=0.16,P=0.692);1、3和5年无瘤生存率分别67.1％、38.2％、16.1％和64.4％、45.5％、23.6％(x2=0.03,P=0.870).结论 微波消融治疗复发性小肝癌与再次手术治疗具有相同的生存率,且创伤小.
目的 比較經腹微波消融與再手術切除治療複髮性小肝癌(單箇癌結節最大直徑不超過3 cm;多箇癌結節數目不超過2箇,其最大直徑總和＜3 cm)的療效.方法 迴顧性分析2007年1月至2010年12月收治的75例複髮性小肝癌患者的臨床資料,其中34例患者行經腹微波消融(微波組),41例行腫瘤再手術切除(手術切除組).比較兩組患者手術情況、AFP值變化、併髮癥髮生率、住院時間及總生存率和無瘤生存率.結果 兩組腫瘤均完全清除;AFP均于3箇月內恢複正常.微波組平均手術時間短于手術組[(91±33) min比(156 ±51)min,t=-6.399 5,P=0.000];微波組術中齣血量少于手術組[(87±62)ml比(254±134)ml,t=-6.691 5,P=0.000];微波組平均住院時間短于手術組[(7.5±2.2)d比(11.3±2.7)d,t=-6.588 8,P=0.000].微波組和手術切除組併髮癥髮生率分彆為2.9％(1/34)和22.0％ (9/41),差異有統計學意義(x2 =5.8127,P=0.016).微波組和手術切除組1、3和5年總生存率分彆為88.1％、68.8％、46.1％和86.1％、71.5％、50.2％(x2=0.16,P=0.692);1、3和5年無瘤生存率分彆67.1％、38.2％、16.1％和64.4％、45.5％、23.6％(x2=0.03,P=0.870).結論 微波消融治療複髮性小肝癌與再次手術治療具有相同的生存率,且創傷小.
목적 비교경복미파소융여재수술절제치료복발성소간암(단개암결절최대직경불초과3 cm;다개암결절수목불초과2개,기최대직경총화＜3 cm)적료효.방법 회고성분석2007년1월지2010년12월수치적75례복발성소간암환자적림상자료,기중34례환자행경복미파소융(미파조),41례행종류재수술절제(수술절제조).비교량조환자수술정황、AFP치변화、병발증발생솔、주원시간급총생존솔화무류생존솔.결과 량조종류균완전청제;AFP균우3개월내회복정상.미파조평균수술시간단우수술조[(91±33) min비(156 ±51)min,t=-6.399 5,P=0.000];미파조술중출혈량소우수술조[(87±62)ml비(254±134)ml,t=-6.691 5,P=0.000];미파조평균주원시간단우수술조[(7.5±2.2)d비(11.3±2.7)d,t=-6.588 8,P=0.000].미파조화수술절제조병발증발생솔분별위2.9％(1/34)화22.0％ (9/41),차이유통계학의의(x2 =5.8127,P=0.016).미파조화수술절제조1、3화5년총생존솔분별위88.1％、68.8％、46.1％화86.1％、71.5％、50.2％(x2=0.16,P=0.692);1、3화5년무류생존솔분별67.1％、38.2％、16.1％화64.4％、45.5％、23.6％(x2=0.03,P=0.870).결론 미파소융치료복발성소간암여재차수술치료구유상동적생존솔,차창상소.
Objective To compare the efficacy of open microwave ablation and repeat hepatectomy for recurrent small hepatocellular carcinoma.Methods The clinical data of 75 patients with recurrent small HCC who were admitted to our hospital from January 2007 to December 2010 were retrospectively analyzed.34 received microwave ablation (MWA group) and 41 received repeat hepatectomy (hepatectomy group).The perioperative condition,liver function recovery,the variation of AFP level,mobidities,hospitalization time and overall survival rate and disease-free survival rate were compared.Results The rate of complete elimination to tumor tissue was 100％ and the AFP levels returned to normal within 3 months in both groups.The mean average operation time in MWA group was shorter than that in hepatectomy group [(91 ±33) min vs (156 ±51) min,t =-6.399 5,P =0.000].The blood loss in MWA group was smaller than that in hepatectomy group [(87 ±62) ml vs (254 ± 134) ml,t =-6.691 5,P =0.000].Patients in PFRA group had a shorter hospital stay [(7.5 ± 2.2) d vs (11.3 ± 2.7) d,t =-6.588 8,P =0.000].The mobidities of the MWA group and hepateetomy group were 2.9％ (1/34) and 22.0％ (9/41),respectively (x2 =5.812 7,P =0.016).The overall survive rate of 1,3 and 5-year were 88.1％,68.8％ and 46.1％ in the MWA group,and 86.1％,71.5％ and 50.2％ in the hepatectomy group (x2 =0.16,P =0.692).The disease free survival rate of 1,3 and 5-year were 67.1％,38.2％ and 16.1％ in the MWA group,and 64.4％,45.5％ and 23.6％ in the hepatectomy group (x2 =0.03,P =0.870).Conclusions MWA can achieve survival benefits equivalent to hepatectomy for recurrent small HCC,and it is less traumatic.
