摘要
目的探讨射频消融术(RFA)对乙型肝炎病毒(HBV)相关性肝癌(HCC)患者肝功能的影响。方法回顾性分析140例HBV相关HCC患者RFA术前、术后3 d、术后1个月肝功能指标,比较治疗前及治疗后肝功能变化情况及影响因素。结果 RFA术后3 d、1个月肝功能异常率分别为87.1%(122/140)、25.7%(36/140),差异有统计学意义(P<0.05)。肝功能Child-Pugh C级患者RFA术后1个月肝功能异常率为81.8%,明显高于A、B级患者(19.5%、23.1%,P均<0.05);消融范围≥3针者术后3 d肝功能异常率为96.2%(51/53),明显高于消融范围≤2针者(81.6%,P<0.05)。乙肝表面抗原(HBsAg)、HBV DNA、甲胎蛋白(AFP)阴性与阳性组,是否合并门脉癌栓的不同分组,RFA术后3 d、1个月的肝功能异常率的差异无统计学意义(P﹥0.05)。结论 RFA虽是微创技术,但在短期仍有不同程度的肝损伤。RFA术前应积极评估患者肝功能、术后密切监测肝功能变化,加强保肝治疗。
Objective To analyze the effect of radiofrequency ablation （RFA） on liver function in patients with hepatitis B virus （HBV） associated hepatocellular carcinoma （HCC）. Methods Retrospectively analysis was performed of the liver function in 140 patients with HBV-associated HCC before and 3 days and 1 month after RFA. Results The rates of abnormal liver function 3 days and 1 month after RFA were 87.1%（122/140）and 25.7%（36/140）, and the differences were statistically significant （P 〈0.05）. The abnormal liver function rate in 1 month after RFA was 81.8%in Child-Pugh C patients ,which was significant higher than Child-Pugh A and B （P 〈 0.05）. The abnormal rate in 3days after RFA in the needle ablation range≥3 （96.2%）was significant higher than needle ablation range ≤2 （P 〈 0.05）. The abnormal liver function rate was unrelated to HBV replication, AFP value, the presence or absence of portal vein tumor thrombus（PVTT）. Conclusion Though RFA is a minimal invasive technique, liver function injury happens in short term. It is important to evaluate liver function actively before RFA and pay attention to the changes after treatment.
出处
《北京医学》
CAS
2014年第3期174-176,共3页
Beijing Medical Journal
基金
吴阶平医学基金会研究基金(WJP-LD-2012075A)
关键词
射频消融术
肝细胞癌
乙型肝炎病毒
肝功能
Radiofrequency ablation（RFA）
Hepatocellular carcinoma
Hepatitis B virus
Liver function
