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1、冷循環(huán)射頻與手術(shù)治療肝癌的臨床研究【摘要】目的研究比較冷循環(huán)射頻與手術(shù)治療肝癌的療效、并發(fā)癥情況、住院花費(fèi)、住院天數(shù)及生活質(zhì)量。方法肝癌患者159例,分為兩組:腫瘤直徑≤5.0cm、單發(fā)腫瘤44例,手術(shù)治療29例,冷循環(huán)射頻治療15例;腫瘤直徑>5.0cm患者115例,手術(shù)治療54例,冷循環(huán)射頻治療61例。冷循環(huán)射頻治療采用Col-tipRFTM系統(tǒng),于超聲引導(dǎo)下將集束射頻治療針穿刺進(jìn)入腫瘤進(jìn)行治療。分組比較兩種治療的肝功能、AFP改變、并發(fā)癥情況、住院天數(shù)及花費(fèi)、生活質(zhì)量評(píng)分等。描述影像學(xué)變化。結(jié)果冷循
2、環(huán)射頻治療對(duì)患者肝臟功能的破壞小于手術(shù)治療。冷循環(huán)射頻治療和手術(shù)治療對(duì)患者AFP水平的影響沒有明顯差異。冷循環(huán)射頻治療并發(fā)癥發(fā)生率,住院天數(shù)及花費(fèi)低于手術(shù)治療,術(shù)后生存質(zhì)量高于手術(shù)治療。腫瘤直徑≤5.0cm、單發(fā)腫瘤,冷循環(huán)射頻和手術(shù)1年生存率及中位生存時(shí)間沒有差異。結(jié)論相對(duì)于手術(shù),冷循環(huán)射頻治療也是一種安全,有效的肝癌治療方法?!娟P(guān)鍵詞】射頻手術(shù)肝癌生活質(zhì)量Clinicalstudyoftheapplicationofradiofrequencyablationandoperationontreatme
3、ntoflivercancer【Abstract】ObjectiveToprobeintothetreatmenteffect,plicationsrate,lifequalityandhospitalizationexpensesofapplyingradiofrequencyablation(RFA)totreatlivercancerandparetoetersofthEirtumorsandorsong44casesinthegroupofsolotumorordiametersequalandl
4、essthan5.0cm,29casesreceivedoperationsand15receivedradiofrequencytreatments,among115casesofthegroupourdiametersmorethan5.0cm,54casesreceivedoperationsand61receivedradiofrequencytreatments.Theoperationsy.Radiofrequencytreatmentorsandperformedradiofrequency
5、treatments,entfrequencyof480kHz,treatmenttime12min.Collecteddataofliverfunction(ALT,ALB,TB),AFP,plications,hospitalizationdaysandexpensesofpatientsreceivingoperationsandradiofrequencytreatmentsrespectively,observedchangesinradiology.Differencesbetentioned
6、dataofpatientsreceivedoperationsandradiofrequencytreatmentsagingeffectofliverfunctionofradiofrequencytreatmententandthosereceivedoperations.Concerningplications,hospitalizationdaysandexpenses,situationsofpatientsreceivedradiofrequencytreatmentsorordiamete
7、rslessthan5.0cm,therelivingrateandqualityoflivingbetentsandthosereceivedoperations.Conclusionparetooperations,RFAtreatmentisalsoakindofeffectiveandsafe、單發(fā)腫瘤組44例,接受手術(shù)治療29例,接受射頻治療15例;直徑>5.0cm組115例,接受手術(shù)治療54例,接受射頻治療61例。患者一般資料見表1。診斷依據(jù)為:B型超聲、CT及肝癌標(biāo)志物——甲胎蛋白(AFP)
8、水平,手術(shù)組術(shù)后病理診斷結(jié)果,冷循環(huán)射頻組肝穿刺活檢結(jié)果。表1患者一般資料情況注:*包括肝腺癌,膽管腺癌及結(jié)腸轉(zhuǎn)移性腺癌;**包括肉瘤樣癌、乳頭狀癌及神經(jīng)內(nèi)分泌癌以及缺乏病理活檢結(jié)果的射頻治療病例1.2方法1.2.1手術(shù)治療方法接受手術(shù)治療的患者兩組共83例。經(jīng)術(shù)前檢查,一般情況良好,肝功能Child-PughA級(jí)(82例)或B級(jí)(1例)。術(shù)前保肝治療后,擇期于全麻下行根治性或姑息性肝臟腫瘤切除,術(shù)式包括:肝左葉切除,肝右葉切