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目的肝癌术后复发和转移是制约肝癌手术疗效的重要因素,如何有效地预防和治疗肝癌术后复发转移是目前研究的重点和难点。本研究旨在探讨肝癌手术中应用氩气刀处理残肝断面对患者术后肿瘤局部复发和生存率的影响。方法回顾性分析329例第二军医大学附属东方肝胆外科医院2010-01-01-2013-01-31不能根治性切除肝癌手术患者,分氩气刀组和传统电刀组,对两组患者术后肿瘤局部复发时间和总生存率进行比较。结果氩气刀组术后3个月、6个月、9个月、1年和2年复发率分别为24.3%、37.8%、69.3%、82.1%和90.8%,传统电刀组分别为30.8%、58.3%、78.4%、89.1%和96.7%,两组中位复发时间分别为(6±1.7)和(4±1.3)个月。传统电刀组局部复发率明显高于氩气刀组,复发时间明显缩短,差异有统计学意义,χ2=11.705,P=0.001。氩气刀组患者术后6个月、1年、2年和3年总生存率分别为91.6%、60.4%、23.3%和10.1%,传统电刀组分别为80.1%、45.8%、12.5%和7.1%,两组中位生存期分别为(16±5.2)和(10±6.5)个月,氩气刀组总生存率明显高于传统电刀组,中位生存期明显延长,差异有统计学意义,χ2=8.746,P=0.003。结论肝癌术中应用氩气刀处理残肝断面可杀灭创面残留肿瘤细胞,减少肿瘤复发,在降低术后肿瘤局部复发率、提高患者总生存率以及延长生存时间等方面有积极的临床意义,值得临床推广。
Objective The recurrence and metastasis of hepatocellular carcinoma is an important factor that restricts the curative effect of hepatocellular carcinoma. How to effectively prevent and treat the recurrence and metastasis of hepatocellular carcinoma is the key and difficult point of current research. The purpose of this study was to investigate the effect of argon knife treatment of residual liver section on local tumor recurrence and survival in patients with liver cancer. Methods Retrospective analysis of 329 cases of Second Affiliated Hospital of Second Military Medical Hepatobiliary Surgery Hospital 2010-01-01-2013-01-31 Patients can not be radical resection of liver cancer surgery, sub-argon gas knife group and the traditional electric knife group, the two groups of patients The local tumor recurrence time and overall survival rate were compared. Results The recurrence rates at 3 months, 6 months, 9 months, 1 year and 2 years after argon knife operation were 24.3%, 37.8%, 69.3%, 82.1% and 90.8% respectively in the argon knife group and 30.8% %, 58.3%, 78.4%, 89.1% and 96.7%, respectively. The median time to recurrence in the two groups were (6 ± 1.7) and (4 ± 1.3) months, respectively. The local recurrence rate was significantly higher in the traditional electrosurgical group than in the argon group, and the recurrence time was significantly shortened (χ2 = 11.705, P = 0.001). The 6-month, 1-year, 2-year and 3-year overall survival rates were 91.6%, 60.4%, 23.3% and 10.1% in the argon knife group compared with 80.1%, 45.8% and 12.5% And 7.1% respectively. The median survival time of the two groups were (16 ± 5.2) and (10 ± 6.5) months, respectively. The overall survival rate of the argon knife group was significantly higher than that of the traditional electrosurgical group, and the median survival time was significantly longer Statistical significance, χ2 = 8.746, P = 0.003. Conclusions The application of argon gas knife to treat residual liver section during operation in liver cancer can kill residual tumor cells in the wound and reduce tumor recurrence. It has a positive clinical significance in reducing the local tumor recurrence rate, improving the overall survival rate and prolonging the survival time of patients. Worth clinical promotion.