摘要
目的观察肝癌患者多点射频消融术(2～4针)后肝功能和并发症情况,探讨其安全性及术前肝功能Child分级与术后并发症的关系。方法选择我院2008年2月—2012年2月就诊的符合条件的肝癌患者43例,记录所有患者术前及术后第5天肝功能指标、术后5 d内出现的并发症及其与术前肝功能Child分级的关系及术后第5天肝功能Child分级。结果术后第5天患者ALT水平较术前平均升高(18±32)U/L,AST水平平均升高(22±31)U/L,差异均有统计学有意义(t值分别为-3.689和-4.767,P<0.05);ALB水平较术前平均下降(4.04±2.33)g/L,差异有统计学意义(t=11.381,P<0.05);DBiL水平较术前平均升高(0.40±1.22)μmol/L,IBiL水平较术前平均升高(1.18±3.99)μmol/L,差异均无统计学意义(t值分别为-0.213和-1.942,P>0.05)。术后5 d内发生肝区疼痛40例次,发热36例次,腹胀20例次,恶心5例次,电极板处皮肤灼伤2例次,呕吐1例次,胸腔积液1例次,针道感染1例次。肝功能Child分级,术前A级38例,B级5例;术后A级33例,B级10例。患者术后5 d内并发症除腹胀和胸腔积液在不同术前Child分级间差异有统计学意义,余比较差异均无统计学意义(P>0.05)。结论多点射频消融术治疗肝癌安全有效,术前评价和改善肝功能十分重要。射频消融术后患者并发症主要为肝区疼痛、发热、腹胀、恶心。术前肝功能Child B级患者多点射频消融术后更容易出现腹胀,术前应积极改善肝功能,提高肝脏储备能力,以减少术后并发症的发生,进一步提高多点射频消融术的安全性。
Objective To observe the liver function and complications after muhipoint radiofrequency ablation （ two to four stitches） for patients with heptocellular carcinoma and to investigate its safety and the relationship between preoperative liver function, Child grading and postoperative complications. Methods 43 eligible patients with heptocellular carcinoma admitted to our hospital from February 2008 to February 2012 were selected. Liver function indexes of all the patients were recorded before the operation and five days after operation. The complications occurred five days after operation, Child grading before operation and five days after operation were also recorded. Results The levels of ALT and AST were significantly increased by an average of （ 18 ± 32） U/L and （22 ± 31 ） U/L respectively five days after operation （ t = - 3.689 and -4. 767, P 〈 0.05 ） . The level of ALB was significantly decreased compared with before the operation （t = 11. 381, P 〈0. 05 ） . The levels of DBiL and IBiL were increased by an average of （0.40±1.22） μmol/L and （ 1.18 ±3.99） μmol/L compared with before the operation without statistical significance （t = -0. 213 and - 1. 942, P 〉 0. 05 ） . Within five days after operation, liver pain occurred 40 case - times, fever 36 case - times, nausea 5 case - times, skin burn in battery lead plate areas 2 case - times, vomit one case - time, plernal effusion one case - time and pin site infection one case - time. As for liver function Child grading, 38 cases were grade A and 5 cases were grade B before operation; 33 cases were grade A and 10 cases were grade B after operation. Abdominal distension and pleural effusion between patients with different Child grading showed statistically significant differences within five days after operation. But other complications showed no statistically differences （ P 〉 0. 05 ） . Conclusion Multipoint radiofrequeney ablation is safe and effective in the treatment of heptocellular carcinoma, but preoperative assessment and improvement of liver function is of great importance. The complications after muhipoint radiofrequency ablation are mainly liver pain, fever, abdominal distension and nausea. Patients with Child B grading of liver function before operation are more likely to have abdominal distension after operation, so preoperative liver function improvement should be emphasized to increase liver reserving capacity in order to reduce postoperative complications, thus improving the safety of muhipoint radiofrequency ablation.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第27期3121-3124,共4页
Chinese General Practice
关键词
肝癌
导管消融术
肝功能
手术后并发症
Liver neoplasms
Catheter ablation
Liver function
Postoperative complications
