微波消融与腹腔镜肝叶切除术治疗肝血管瘤患者疗效研究*

doi:10.3969/j.issn.1672-5069.2024.01.030

摘要/Abstract

摘要： 目的比较微波消融(MWA)与腹腔镜肝叶切除术(LH)治疗肝血管瘤(HH)患者的疗效。方法 2018年1月～2022年3月我院收治的94例HH患者,其中46例接受MWA治疗,48例接受LH治疗,术后随访1年。采用ELISA法检测血清肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平。结果 MWA组术中出血量、血流阻断时间、手术时间和术后住院日为(17.2±3.5)mL、(22.8±4.4)min、(158.0±31.8)min和(6.3±1.9)d,均显著少于或短于LH组【分别为(208.4±39.7)mL、(26.3±5.1)min、(228.5±43.2)min和(8.1±2.4)d,P<0.05】;手术前后,两组肝功能指标变化无统计学差异(P>0.05);在术后5 d,MWA组血清TNF-α和IL-6水平分别为(51.3±7.5)pg/ml和(18.3±3.5)pg/ml,均显著低于LH组【分别为(65.9±10.4)pg/ml和(26.8±4.9)pg/ml,P<0.05】;术后,MWA和LH治疗组感染或胆漏等并发症发生率分别为4.4%和8.3%,无显著性差异(P>0.05);术后随访1年发现,LH组无肝内血管瘤复发,MWA组43例(93.5%)病灶缩小幅度超过75%。结论采取MWA或LH治疗HH患者均能获得良好的疗效,但考虑到手术风险,在条件允许时应尽可能地采取MWA手术治疗。

关键词: 肝血管瘤, 微波消融, 腹腔镜肝叶切除术, 治疗

Abstract: Objective The purpose of this study was to compare the efficacy of microwave ablation (MWA) and laparoscopic hepatectomy (LH) in the treatment of patients with hepatic hemangiomas (HH). Methods 94 patients with HH were admitted to our hospital between January 2018 and March 2022, and were divided into two groups, receiving MWA in 46 cases and LH in 48 cases. All patients were followed-up for 1 year after operation. Serum tumor necrosis factor -α (TNF-α) and interleukin-6 (IL-6) levels were determined by ELISA. Results The intraoperative blood loss, blood flow blocking time, operation time and hospital stay in MWA-treated patients were (17.2±3.5)mL, (22.8±4.4)min, (158.0±31.8)min and (6.3±1.9)d, all significantly less or shorter than [(208.4±39.7) mL, (26.3±5.1)min, (228.5±43.2)min and (8.1±2.4)d, respectively, P<0.05] in patients receiving LH treatment; there were no significant differences as respect to liver function tests between the two groups before and after operation (P>0.05); five days after operation, serum TNF-α and IL-6 levels in patients with MWA treatment were (51.3±7.5)pg/ml and (18.3±3.5)pg/ml, both significantly lower than [(65.9±10.4)pg/ml and (26.8±4.9)pg/ml, respectively, P<0.05] in LH-treated patients; the incidences of post-operational complications, such as infections and bile leakage, in MWA- and LH-treated patients were 4.4% and 8.3% (P>0.05); at the end of one-year follow-up, no intrahepatic tumors relapsed in LH-treated patients, and the tumors shrank to 25% in 43 cases (93.5%) in MWA-treated patients. Conclusion The patients with HH could be managed by both MWA or LH, but we recommend the former because of the less body inflammatory reactions and rapid recovery.

Key words: Hepatic hemangiomas, Microwave ablation, Laparoscopy hepatectomy, Treatment

陶国清, 许其威, 李海锋. 微波消融与腹腔镜肝叶切除术治疗肝血管瘤患者疗效研究^*[J]. 实用肝脏病杂志, 2024, 27(1): 117-120.

Tao Guoqing, Xu Qiwei, Li Haifeng. Comparison of microwave ablation and laparoscopic hepatectomy in the treatment of patients with hepatic hemangiomas[J]. Journal of Practical Hepatology, 2024, 27(1): 117-120.

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微波消融与腹腔镜肝叶切除术治疗肝血管瘤患者疗效研究^*

Comparison of microwave ablation and laparoscopic hepatectomy in the treatment of patients with hepatic hemangiomas

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