射频消融联合断流术治疗肝癌合并门静脉高压症69例分析-论文.pdf

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1、中国实用外科杂志2013年11月第33卷第11期·967·论著文章编号：1005—2208(2013)11-0967—03射频消融联合断流术治疗肝癌合并门静脉高压症69例分析丁振昊，穆毅，蒋力，张珂，黄容海，鲁岩，赫嵘，李勤涛，郭立民，李宝亮，贾哲【摘要】目的总结射频消融联合断流术治疗原发性肝癌合并门静脉高压症的临床经验。方法对2004年6月至2012年6月首都医科大学附属北京地坛医院肝胆外科69例(治疗组)行射频消融联合断流术治疗原发性肝癌合并门静脉高压症的资料进行回顾性分析，并与同期83例(对照组)行肝部分切除联合断流术的病例进行对照研究。观察病人术后肝功能损害程度、术后并发症发生率、术

2、后食管胃底静脉出血复发率、术后总体存活率和术后无瘤存活率等。结果两组均无围手术期死亡。治疗组术后肝功能损害主要为轻中度，损害程度显著低于对照组(p<0．05)。治疗组术后并发症的发生率低于对照组(P<0．05)。两组术后1、3、5年总存活率、无瘤存活率及食管胃底静脉复发出血率差异无统计学意义。结论在严格掌握适应证的前提下，射频消融联合断流术比肝部分切除联合断流术肝功能损伤小、术后并发症少，且射频消融联合断流术可以获得与肝部分切除联合断流术相似的远期存活率。【关键词】原发性肝癌；门静脉高压症；射频消融；断流术中图分类号：R6文献标志码：ARadiofrequencyablationcombin

3、edwithdevascularizationintreatingprimarylivercancerwithportalhypertension：Ananaiysisof69casesDINGZhen-hao，MUYi，JIANGLi，eta1．DepartmentofHepatobiliarySurgery,BeqingDitanHospital，CapitalMedicaleBeqing100015,ChinaCorrespondingauthor：MUYi，E—mail：muyiO01@sina．comAbstractObjectiveTosummarizetheclinicalex

4、perienceofradiofrequencyablationcombinedwithdevascularizationintreatingprimarylivercancerwithportalhypertension．MethodsTheclinicaldataof69casesofprimarylivercancerwithportalhypertensiontreatedwithradiofrequencyablationcombinedwithdevascularizationfromJune2004toJune2012inDepartmentofHepatobiliarySur

5、gery，BeijingDitanHospitalofCapitalMedicalUniversity(thestudygroup)wereanalyzedretrospectively．Atthesametime，theclinicaldataof83casestreatedwiththepartialhepatectomycombinedwithdevascularization(thecontrolgroup)werecomparedwiththedataofthestudygroup．Postoperativeliverfunctiongrade，complications，theh

6、emorrhagerecurrencerateofgastroesophagealvarices，postoperativeoverallsurvivalandpostoperativetumor—freesurvivaloftwogroupswereobserved．ResultsTherewasnodeadcaseintwogroups．Inthestudygroup，liverdysfunctionwasmainlymildormoderatedegree，andtheextentofliverfunctiondamagewassignificantlylowerthanthecont

7、rolgroup(P<0．05)．Postoperativecomplicationincidenceinstudygroupwaslowerthanthatinthecontrolgroup<0．05)．Twogroupshadnodifferenceinpostoperative1一，3一，and5-yearoverallsurvivalrate，tumor—freesurvivalrateandgast