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目的 :评价射频及手术切除在小肝癌治疗中的价值。方法 :分别对我院肝内科及肝外科随机选取的 2 0 0 3年采用射频和手术切除治疗小肝癌的病例各 10 0例 ,对两组在住院费用、住院天数、肝功能恢复时间、术后 1年复发率及并发症等方面进行比较。结果 :射频治疗组患者术后肝功能恢复时间为 9.0 9± 4 .5 9d ,少于手术组 10 .5 5± 3.0 9d(P <0 .0 1) ;射频治疗组患者术后并发症 (发热 ,黄疸 )比手术组患者明显少 (P <0 .0 0 1) ,且持续时间短 ;对于直径 3.0cm以下的肿瘤 ,射频治疗组患者术后 1年的肿瘤复发率等同于手术组 (p >0 .0 5 ) ,而直径在 3.0～ 5 .0cm的肿瘤 ,射频治疗组患者术后 1年的肿瘤复发率明显高于手术组 (P <0 .0 1) ;射频治疗组患者平均住院费用是 2 35 0 4 .2 8± 4 936 .6 2元 ,手术组为 2 2 6 6 3.6 6± 394 9.6 1元。两组基本相当 (p >0 .0 5 ) ;射频治疗组患者平均住院天数为 14 .4 9± 7.6 1d ,少于手术组 17.5 8± 4 .87d(P <0 .0 1)。结论射频治疗是一种创伤小、恢复快、安全性高的治疗方法 ,其对于 3cm以下的肿瘤的疗效等同于手术切除。且其治疗费用与手术切除相当。严格掌握射频治疗的指征是降低术后复发的关键。
Objective: To evaluate the value of radio frequency and surgical resection in the treatment of small liver cancer. Methods: A total of 100 cases of small hepatocellular carcinoma treated by radiofrequency and surgical resection were randomly selected in our department of Department of Hepatology and Liver Surgery in 2003. The hospitalization cost, hospitalization days, recovery time of liver function, 1 year after the recurrence rate and complications were compared. Results: The recovery time of postoperative liver function in patients in radiofrequency treatment group was 9.09 ± 4.59 days, less than that in operative group (10.55 ± 3.09 days, P <0.01); postoperative complications Fever, and jaundice) were significantly less than those in the operation group (P <0.01), and the duration was short. For tumors less than 3.0 cm in diameter, the recurrence rate at 1 year after RFA was the same as that in the operation group p> 0.05). The tumor recurrence rate in the radiofrequency treatment group was significantly higher than that in the surgery group (P <0.01) when the diameter was 3.0-5.0cm. The average radiofrequency Hospitalization costs were 2 35 0 4 .2 8 ± 4 936 .62 yuan for the surgery group and 2 266 3.6 6 394 9.61 yuan for the surgery group. The average length of stay in patients in the radiofrequency group was 14.49 ± 7.6 days, which was less than the 17.58 ± 4.87 days in the operation group (P <0.01). Conclusion RFA is a less traumatic, faster recovery and more safe treatment, which is equivalent to surgical resection for tumors less than 3 cm. And its treatment costs and surgical resection. Strict control of RFI indications is the key to reducing postoperative recurrence.