（南京大学医学院附属南京鼓楼医院集团宿迁市人民医院普外科 江苏 宿迁 223800）
【摘要】目的：研究经皮射频消融术与手术切除治疗小肝癌患者的近远期疗效及对患者满意度的影响。方法：本次选择对象为小肝癌患者，根据电脑随机分配的原则将60例患者分为两组，即观察组与对照组，分别实施不同治疗。结果：观察组小肝癌患者1～3年生存率与对照组相比无统计学意义，P>0.05。观察组患者满意度与对照组相比较高，差异有统计学意义，P＜0.05。结论：经皮射频消融术治疗小肝癌患者的近远期疗效十分显著，值得研究。
【关键词】经皮射频消融术；小肝癌；近远期疗效
【中图分类号】R735.7 【文献标识码】A 【文章编号】2095-1752（2018）32-0016-02
Peripheral and long-term effects of percutaneous radiofrequency ablation and surgical resection for small hepatocellular carcinoma patients and their impact on patient satisfaction,Wang Qile*,Feng Wei,Ma Yao,Lin Bin. Dep of General surgery ,Suqian people's Hospital 223800,China
【Abstract】Objective To study the short-term and long-term effects of percutaneous radiofrequency ablation and surgical resection for small hepatocellular carcinoma patients and their impact on patient satisfaction. Methods The selected subjects were small liver cancer patients. According to the principle of random computer allocation, 60 patients were divided into two groups, namely, the observation group and the control group, and different treatments were performed. Results The 1-3-year survival rate of small liver cancer patients in the observation group was not statistically significant compared with the control group, P>0.05. The patient satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion The short-term and long-term effects of percutaneous radiofrequency ablation in the treatment of small liver cancer patients are very significant and worthy of study.
【Key words】Percutaneous radiofrequency ablation; Small liver cancer;Short-term and long-term effects
Peripheral and long-term effects of percutaneous radiofrequency ablation and surgical resection for small hepatocellular carcinoma patients and their impact on patient satisfaction,Wang Qile*,Feng Wei,Ma Yao,Lin Bin. Dep of General surgery ,Suqian people's Hospital 223800,China
【Abstract】Objective To study the short-term and long-term effects of percutaneous radiofrequency ablation and surgical resection for small hepatocellular carcinoma patients and their impact on patient satisfaction. Methods The selected subjects were small liver cancer patients. According to the principle of random computer allocation, 60 patients were divided into two groups, namely, the observation group and the control group, and different treatments were performed. Results The 1-3-year survival rate of small liver cancer patients in the observation group was not statistically significant compared with the control group, P>0.05. The patient satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion The short-term and long-term effects of percutaneous radiofrequency ablation in the treatment of small liver cancer patients are very significant and worthy of study.
【Key words】Percutaneous radiofrequency ablation; Small liver cancer;Short-term and long-term effects
肝癌为临床常见恶性肿瘤疾病，主要是由于人体肝脏间叶组织或上皮组织恶性肿瘤所致，其发病机制尚未明确，研究认为与化学物质、病毒性肝炎、性激素、酒精和环境因素密切相关[1]。
1.资料/方法
1.1 基线资料
研究对象均为小肝癌患者，例数60例，采用抽签或随机的方式对研究对象进行分组，分为观察组、对照组，例数分别为30例。
观察组：男、女占比各为19:11，经计算后中位年龄为（50.21±1.34）岁。
对照组：男、女占比各为20:10，经计算后中位年龄为（50.64±1.88）岁。
2组小肝癌患者的各项基线资料相比无明显差异性，即可用P>0.05表示两者之间具有可比性。
1.2 方法
1.2.1对照组采用方法 本组研究对象实施手术切除治疗，给予患者全麻，并取患者平卧位，必要情况下在腰部增加气垫，进行常规消毒和铺巾后，在患者右肋下缘部位做一道切口，后逐层进腹，入腹后对患者肿瘤位置、周围脏器情况以及肿瘤大小进行观察，对手术方式进行评估，后根据手术需求将肝周韧带切断，并游离出肝脏，后将肝的十二指肠韧带的脉管系统进行分离，最后实施肝癌切除术，术后对患者有无出血进行密切观察，并对腹腔采用蒸馏水进行清洗，放置引流管，最后逐层关腹。
1.2.2观察组采用方法 本组研究对象采取经皮射频消融术治疗，选择射频治疗仪操作，型号为RF2000型。于CT下引导进针，需防止对胆管和肝内主要动脉造成损伤，将电极针沿着肿瘤长径插入底部位置，实施射频消融治疗。待治疗结束后，需加热针尖至70～80摄氏度，后将针头拔出，达到止血和消融进针道作用。
1.3 观察指标
对比且分析两组小肝癌患者术后1年、2年、3年生存率、患者满意度。
1.4 统计学方法
在本次研究内容中采取SPSS26.0软件，两组数据对比不同，即用P＜0.05表示两组具有统计学意义，具有差异。
2.结果
2.1 对比2组术后1～3年生存率
观察组患者1～3年生存率与对照组相比无统计学意义，P>0.05。见表1。
表1 60例患者术后1-3年生存率（%）
2.2 比较两组患者满意度
观察组小肝癌患者96.67%（29/30）。
对照组小肝癌患者70.00%（21/30）。
观察组患者满意度与对照组相比较高，差异有统计学意义，P＜0.05。
3.讨论
肝癌首选的治疗方式为手术治疗，其能够使患者生存期得以延长，同时具有较好的治疗效果。但研究认为，手术治疗易受到肿瘤大小和位置的影响，导致其增加手术难度，增加肝脏和肝内胆管系统损伤、癌细胞肝内扩散的风险，进而引起较多严重并发症，比如肝衰竭、感染和腹水等，使肝功能受损[2]。而经皮射频消融术能够弥补上述不足，具有诸多优势，如安全性高、操作简单、有效率高、微创等，其主要是通过在肿瘤内部将针型电极释放交流电磁波，使肿瘤组织震动，形成摩擦热，当温度在60摄氏度以上时，即可达到肿瘤出血坏死的目的，进而杀灭肿瘤细胞蛋白变性组织，达到治疗目的。
本文研究数据显示，观察组小肝癌患者1～3年生存率与对照组相比无统计学意义，P>0.05。观察组患者满意度与对照组相比较高，差异有统计学意义，P＜0.05。
综上所述，经皮射频消融术治疗小肝癌患者的近远期疗效十分显著，值得进一步推广与探究。
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[2]王细文,王巍威,赵宏智,等.经皮射频消融术与腹腔镜肝癌切除术治疗小肝癌的临床疗效观察[J].西部医学,2017,29(2):183-186.
论文作者:汪启乐（通讯作者）,冯伟,马垚,林斌
论文发表刊物:《医药前沿》2018年32期
论文发表时间:2018/12/7
标签：患者论文; 肝癌论文; 射频论文; 统计学论文; 生存率论文; 对照组论文; 肿瘤论文; 《医药前沿》2018年32期论文;