作　　者： (谢宣刚）; (王翔翔）; (陈贵平）;

机构地区： 达州市中心医院普通外科,四川达州635000

出　　处： 《临床误诊误治》 2017年第8期100-104,共5页

摘　　要： 目的探讨超声引导下经皮微波消融术治疗原发性小肝癌的临床效果。方法将2011年1月—2013年2月达州市中心医院普通外科收治的原发性小肝癌80例根据随机数字表法随机分为观察组和对照两组各40例,观察组予超声引导下经皮微波消融术治疗,对照组予手术切除治疗。观察比较两组手术情况、治疗效果、术后并发症情况及预后情况。结果观察组手术时间、术中出血量、术中输血量明显短于或少于对照组,差异均有统计学意义(P<0.05)。术后观察组丙氨酸转氨酶及天冬氨酸转氨酶值明显低于对照组,白蛋白及总胆红素值明显高于对照组,术后住院时间明显短于对照组,术后并发症发生率低于对照组,差异均有统计学意义(P<0.05)。两组术后病灶根除率,随访期间复发率,术后3、6、12、24、36个月无瘤生存率及术后6、12、24、36个月总生存率比较差异均无统计学意义(P>0.05)。结论超声引导下经皮微波消融术治疗原发性小肝癌效果与手术治疗基本相当,但超声引导下经皮微波消融术对机体损伤小、并发症少,且患者术后肝功能恢复较快。 Objective To investigate clinical effect of ultrasound-guided percutaneous microwave ablation in treatment of primary small hepatocellular carcinoma.Methods A total of 80 patients with small hepatocellular carcinoma admitted during January 2011 and February 2013 were divided into observation （n=40） and control group （n=40） according to random number table method.Observation group was treated with ultrasound-guided percutaneous microwave ablation, while control group was treated with surgical resection.The operative condition, therapeutic effect, complications and prognosis were observed and compared between the two groups.Results Values of operative time, intraoperative blood loss and blood transfusion volumes were significantly lower than those in control group （P〈0.05）.In observation group, postoperative alanine transarninase （ALT） and aspartate aminotransferase （AST） values were significantly lower, while albumin （ALB） and total bilirubin （TB） values were significantly, and postoperative hospitalization time was significantly shorter, while postoperative complication rate was significantly lower than those in control group （P〈0.05）.There were no significant differences in eradication rate of lesions, recurrence rate during follow-up, disease free survival rates in postoperative 3rd, 6th, 12th, 24th and 36th months and the total survival rates in postoperative 6th, 12th, 24th and 36th months between two groups （P〉0.05）.Conclusion Ultrasound-guided percutaneous microwave ablation in treatment of primary small hepatocellular carcinoma can achieve similar effect of by surgical treatment.However, percutaneous microwave ablation has less damage and complication with quicker recovery of liver function.

关 键 词： 肝肿瘤 超声外科手术 消融技术