腹腔镜射频消融与腹腔镜肝切除治疗慢性乙型肝炎相关特殊部位原发性肝癌的临床效果比较

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摘要目的评价腹腔镜射频消融（LRFA）与腹腔镜肝切除术（LH）治疗慢性乙型肝炎患者相关特殊部位原发性肝细胞癌（HCC）的效果及其安全性。方法回顾性分析2012年1月～2017年12月广东医科大学附属医院收治的97 例慢性乙型肝炎相关特殊部位HCC 患者，共116 个结节。根据不同的治疗方法分为两组，LRFA 组（45 例）行LRFA治疗，LH 组（52 例）采用LH 方法，术后随访2年，比较两组总生存率、术后肝功能变化、住院时间及并发症发生率。结果 LRFA 组术后瘤体完全消融率为100%。LRFA 组术后1、2年总生存率为90.7%、84.0%，LH 组为91.4%、82.5%，两组比较差异无统计学意义（P＞0.05）。LRFA 术后丙氨酸转氨酶水平低于LH 组，差异有统计学意义（P＜0.05)。LRFA 组住院时间短于LH 组，差异有统计学意义（P＜0.05)。两组的并发症发生率比较，差异无统计学意义（P＞0.05）。结论 LRFA 与LH 都是慢性乙型肝炎相关特殊部位HCC 患者的根治方式，但是LRFA 对肝功能损伤小，并发症发生率低，拓宽了射频消融的适用范围，对治疗特殊部位HCC 更具优势。

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	戴维
	莫聪
	沙荣贵
	戴嘉良
	蔡观河
	缪辉来
	包仕廷
	陈明
	谭小宇
	李明意
	陈念平

关键词 ：慢性乙型肝炎, 原发性肝细胞癌, 腹腔镜手术, 肝切除, 射频消融, 总生存率

Abstract：Objective To evaluate the effect and safety of laparoscopic radiofrequency ablation (LRFA) and laparoscopic hepatectomy (LH) in the treatment of chronic hepatitis B virus related special location primary liver cancer. Methods A retrospective analysis of 97 patients with chronic hepatitis B-related special site HCC patients admitted to the Affiliated Hospital of Guangdong Medical University from January 2012 to December 2017 was made，a total of 116 nodules. According to different treatment methods，they were divided into two groups. LRFA group (45 cases) received LRFA treatment，LH group (52 cases) received LH method，and were followed up for 2 years after surgery. The overall survival rate，postoperativ，liver function changes，hospital stay and incidence of complications were compared between two groups. Results The complete ablation rate of tumors in the LRFA group was 100%. The 1- and 2-year overall survival rates in the LRFA group were 90.7% and 84.0%，and those in the LH group were 91.4% and 82.5%. There was no significant difference between the two groups (P＞0.05). The level of alanine aminotransferase after LRFA was lower than that of LH group，the difference was statistically significant (P＜0.05). The hospital stay in the LRFA group was shorter than that in the LH group，and the difference was statistically significant (P＜0.05). The incidence of complications between the two groups was not statistically significant (P＞0.05).Conclusion For chronic hepatitis B virus related special location small primary liver cancer，both LRFA and LH are effective. However，LRFA not only has less liver function damage and fewer complications，but also broadens the scope of application of radiofrequency ablation，which is more advantageous for treating special location liver cancer.

Key words： Chronic hepatitis B Primary liver cancer Laparoscopic surgery Liver resection Radiofrequency ablation Overall survival rate

基金资助:广东医科大学附属医院临床研究基金资助项目（LCYJ2018C002）

引用本文:

戴维; 莫聪; 沙荣贵; 戴嘉良; 蔡观河; 缪辉来; 包仕廷; 陈明; 谭小宇; 李明意; 陈念平. 腹腔镜射频消融与腹腔镜肝切除治疗慢性乙型肝炎相关特殊部位原发性肝癌的临床效果比较[J]. 中国当代医药, 2020, 27(18): 42-45.
DAI Wei; MO Cong; SHA Rong-gui; DAI Jia-liang; CAI Guan-he; MIAO Hui-lai; BAO Shi-ting; CHEN Ming; TAN Xiao-yu; LI Ming-yi; CHEN Nian-ping. Clinical effect comparison of laparoscopic radiofrequency ablation and laparoscopic hepatectomy in the treatment of chronic hepatitis B virus related special location small primary liver cancer. 中国当代医药, 2020, 27(18): 42-45.

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