论文部分内容阅读
目的探讨复杂肝切除术中辅助使用射频消融技术的可行性。方法回顾性分析2007年3月至2013年2月间收治的行巨大或多发肝肿瘤切除术的32例患者资料,其中14例患者(射频辅助切肝组)术中辅助使用射频消融术,18例患者(常规切肝组)行常规肝脏切除术。比较两组患者手术时间、术中出血量、肝门阻断时间、术后住院时间、术后肝功能和术后并发症。结果射频辅助切肝组患者术中出血量为150~1200ml,中位出血量350ml,常规切肝组术中出血量为350~1500ml,中位出血量750ml,组间比较差异有统计学意义(P<0.001)。射频辅助切肝组肝门阻断时间肝门阻断时间为0~15min,中位时间3min,常规切肝组肝门阻断时间为5~35min,中位时间9.5min,组间比较差异有统计学意义(P<0.001)。两组患者的手术时间、术后住院时间、术后第3天及第7天白蛋白、丙氨酸转氨酶、总胆红素、血小板水平比较,差异无统计学意义(均P>0.05)。两组均无死亡、胆漏、出血、腹腔感染等并发症。结论射频消融辅助的肝切除术安全有效、出血少、肝门阻断时间短,但相比常规手术,费用昂贵且精准性不足可能是制约其临床普及的主要因素。
Objective To investigate the feasibility of assisted radiofrequency ablation in complicated hepatectomy. Methods The data of 32 patients who underwent massive or multiple hepatectomy from March 2007 to February 2013 were retrospectively analyzed. Among them, 14 patients (RFA group) were assisted by radiofrequency catheter ablation, Cases of patients (conventional hepatectomy group) underwent conventional hepatectomy. The operation time, intraoperative blood loss, hilar blocking time, postoperative hospital stay, postoperative liver function and postoperative complications were compared between the two groups. Results The frequency of intraoperative blood loss was 150 ~ 1200ml and the median blood loss was 350ml in patients with RFA. The blood loss in the routine hepatectomy group was 350 ~ 1500ml and the median blood loss was 750ml. There was significant difference between the two groups P <0.001). The frequency of hepatic portal occlusion was 0-15 min in the time of hilar blocking in RFA group, and the median time was 3 min. The time of hilar blocking in routine hepatectomy group was 5-35 min and the median time was 9.5 min Statistical significance (P <0.001). There was no significant difference in the operation time, postoperative hospital stay, albumin, alanine aminotransferase, total bilirubin and platelet on the 3rd and 7th day after operation between the two groups (all P> 0.05). No death, bile leakage, bleeding, abdominal infection and other complications occurred in both groups. Conclusions Radiofrequency ablation assisted hepatectomy is safe and effective, with less bleeding and shorter hilar block time. However, compared with conventional surgery, it is expensive and imprecise, which may be the main factor restricting its clinical application.