射频辅助肝切除术VS单纯性肝切除术治疗肝癌的前瞻性随机对照研究

发布时间：2018-05-29 11:02

本文选题：肝细胞性肝癌 + 射频辅助肝切除术　；参考：《第三军医大学》2015年硕士论文

【摘要】：目的前瞻性比较射频辅助肝切除术与单纯性肝切除术在治疗肝细胞性肝癌的围手术期疗效。方法通过运用前瞻性随机对照研究的方法,我们在2012年12月至2014年10月期间第三军医大学第一附属医院肝胆外科收治的肝癌患者中,一共将92例肝细胞性肝癌的患者随机性地分配到两个治疗组中,其中单纯性肝切除术组(LR)有46例,射频辅助肝切除术组(RF+LR)有46例。主要观察指标包括各组患者术中的出血量和肝门阻断时间;次要观察指标是患者术后的肝功能、并发症发生率、死亡率、住院时间。结果射频辅助肝切除术组(RF+LR)与单纯性肝切除术组(LR)在平均失血量方面,RF+LR组显著减少(300 vs 400ml,P=0.049);肝门阻断的时间在RF+LR组明显降低(10 vs 15min,P=0.014)。术后肝功能和总体的并发症发生率两组间无统计学差异,住院时间RF+LR组明显缩短(18.5 vs 22.5天,P=0.002)。两组均无死亡的患者。结论射频辅助肝切除术在肝细胞性肝癌的治疗中能够有效的减少术中出血量、肝门阻断时间和住院时间,对于合并肝硬化重的患者应慎用该方法。
[Abstract]:Objective to compare the perioperative efficacy of radiofrequency assisted hepatectomy and simple hepatectomy in the treatment of hepatocellular carcinoma. Methods from December 2012 to October 2014, we used a prospective randomized controlled study of liver cancer patients admitted to the first affiliated Hospital of the third military Medical University in the department of hepatobiliary surgery. A total of 92 patients with hepatocellular carcinoma were randomly assigned to two treatment groups: 46 cases in simple hepatectomy group and 46 cases in radiofrequency assisted hepatectomy group. The main outcome measures were the amount of blood loss during operation and the time of hepatic hilus occlusion. The secondary indexes were liver function, incidence of complications, mortality rate and hospitalization time. Results the mean blood loss in radiofrequency assisted hepatectomy group and simple hepatectomy group was significantly lower than that in RF LR group (300 vs 400 ml / L), and the time of hepatic hilus occlusion in RF LR group was significantly lower than that in RF LR group (n = 10 vs 15 min, P < 0. 014). There was no significant difference in postoperative liver function and overall incidence of complications between the two groups. The length of stay in the RF LR group was significantly shorter than that in the RF LR group (18.5 vs 22.5 days). There was no death in both groups. Conclusion radiofrequency assisted hepatectomy can effectively reduce intraoperative blood loss, hepatic portal occlusion time and hospitalization time in the treatment of hepatocellular carcinoma. This method should be used with caution in patients with severe liver cirrhosis.
【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7

【参考文献】