No-touch射频消融术治疗小肝癌的效果
| 作者: |
1崔虎啸,
1侯森,
1王耀东,
2王芳杰,
1张建松,
1时永
1 许昌市中心医院肝胆外科，河南 许昌 461000 2 许昌市中心医院药学部，河南 许昌 461000 |
| 通讯: |
崔虎啸
Email: cuihx1@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.01.018 |
| 基金: | 2019年河南省医学科技攻关计划(联合共建)项目(LHGJ20191396)。 |
摘要
目的：探究No-touch射频消融技术(No-touch radiofrequency ablation，No-touch-RFA)治疗小肝癌的效果。方法：选择2016年1月至2019年1月于许昌市中心医院就诊的小肝癌患者68例，按照手术方法的不同分为No-touch组(n=32)与传统射频组(n=36)。收集患者的一般资料、术前及术后生化指标[谷丙转氨酶(alanine transaminase，ALT)、总胆红素(total bilirubin，TBIL)、血清白蛋白(albumin，Alb)、甲胎蛋白(alpha fetoprotein，AFP)]，观察患者术后并发症发生情况，并随访2年，记录患者的总生存期、无瘤生存率及复发情况。结果：治疗后，两组患者的AFP均低于治疗前(P<0.05)，两组间AFP比较，差异无统计学意义(P>0.05)；治疗后，两组ALT、TBIL、Alb与治疗前的差异无统计学意义，且两组间的差异无统计学意义(P>0.05)；No-touch组1年、2年总生存率分别为93.75%、87.50%，传统射频组1年、2年总生存率分别为80.56%、66.67%，差异有统计学意义(P<0.05)；No-touch组1年、2年无瘤生存率为84.38%、71.88%；传统射频组1年、2年无瘤生存率分别为66.67%、47.22%，差异有统计学意义(P<0.05)；No-touch组与传统射频组的1年复发率分别为15.63%、25.00%，差异无统计学意义(P>0.05)；No-touch组与传统射频组的2年复发率分别37.50%、52.78%，差异有统计学意义(P<0.05)；No-touch组的并发症发生率为3.13%，传统射频组为8.33%，差异无统计学意义(P>0.05)。结论：No-touch-RFA技术与传统射频消融技术均能降低AFP水平，而No-touch-RFA技术能提高患者的生存期。
关键词：
No-touch射频消融术；小肝癌；生存期；复发；并发症
Curative effects of No-touch radiofrequency ablation on small hepatocellular carcinoma
CorrespondingAuthor: CUI Huxiao Email: cuihx1@126.com
DOI: 10.3978/j.issn.2095-6959.2022.01.018
Foundation: This work was supported by Henan Provincial Medical Science and Technology Research Plan (Joint Co-construction) Project, China (LHGJ20191396).
Abstract
Objective: To explore the curative effects of No-touch radiofrequency ablation (No-touch-RFA) on small hepatocellular carcinoma (SHCC). Methods: A total of 68 patients with SHCC treated in the hospital were enrolled between January 2016 and January 2019. They were divided into a No-touch group (n=32) and a traditional radiofrequency group (n=36) according to different surgical methods. The general data of patients were collected, including preoperative and postoperative biochemical indexes [alanine aminotransferase (ALT), total bilirubin (TBIL), serum albumin (Alb), alpha-fetoprotein (AFP)]. The occurrence of postoperative complications was observed. And patients were followed up for 2 years to record overall survival, disease free survival (DFS) rate and recurrence. Results: After treatment, AFP in the 2 groups was decreased (P<0.05), but there was no significant difference between the 2 groups (P>0.05). There was no significant difference in ALT, TBIL and Alb before and after treatment in the two groups, and there was no significant difference between the 2 groups (P>0.05). The 1-year and 2-year overall survival rates in the No-touch group and the traditional radiofrequency group were 93.75%, 87.50% and 80.56%, 66.67%, and the differences were statistically significant (P<0.05). The 1-year and 2-year DFS rates in the No-touch group and the traditional radiofrequency group were 84.38%, 71.88% and 66.67%, 47.22%, and the differences were statistically significant (P<0.05). The 1-year recurrence rates in the No-touch group and the traditional radiofrequency group were 15.63% and 25.00%, but the difference was not statistically significant (P>0.05). The 2-year recurrence rates in the No-touch group and the traditional radiofrequency group were 37.50% and 52.78%, and the differences were statistically significant (P<0.05). The incidence rates of complications in the No-touch group and the traditional radiofrequency group were 3.13% and 8.33%, and the difference was not statistically significant (P>0.05). Conclusion: Both No-touch-RFA and traditional RFA can reduce AFP level. However, No-touch-RFA can prolong survival of patients.
Keywords：
No-touch radiofrequency ablation; small hepatocellular carcinoma; survival; recurrence; complication