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目的探讨射频消融对小肝癌患者的围术期指标及术后肝功能的影响。方法选取小肝癌患者60例,随机分为观察组与对照组,各30例。对照组给予手术切除治疗,观察组给予射频消融治疗。观察并记录术中失血量、输血量及手术时间、住院时间;采用全自动生化分析仪于治疗前,治疗后7、14 d检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、凝血酶原时间(PT);血糖仪检测空腹血糖(FPG)和餐后2 h血糖(2 h PG),免疫比浊法检测糖化血红蛋白(Hb A1c)。采用SPSS 19.0统计软件对数据进行分析。结果观察组失血量、输血量、手术时间、住院时间明显低于对照组,差异有统计学意义(P均<0.05);治疗后14 d观察组ALT、AST明显低于对照组,差异有统计学意义(P均<0.05)。观察组治疗前后FPG、2 h PG、Hb A1c水平差异无统计学意义(P均>0.05);对照组治疗后FPG、2 h PG水平高于治疗前,且高于观察组,差异有统计学意义(P均<0.05)。结论射频消融能显著降低小肝癌患者失血量、输血量,缩短手术时间及住院时间,使肝功能恢复更快,对血糖水平无显著影响。
Objective To investigate the effect of radiofrequency ablation on perioperative indexes and postoperative liver function in patients with small hepatocellular carcinoma. Methods 60 patients with small hepatocellular carcinoma were randomly divided into observation group and control group, 30 cases each. The control group was given surgical resection and the observation group was given radiofrequency ablation. Observe and record intraoperative blood loss, blood transfusion volume, operation time and length of stay; use automatic biochemical analyzer to detect ALT, AST, and total bilirubin at 7 and 14 days after treatment. TBIL and prothrombin time (PT); blood glucose meter was used to detect fasting plasma glucose (FPG) and postprandial 2 h blood glucose (2 h PG), and immunoturbidimetry was used to detect hemoglobin A1c (Hb A1c). SPSS 19.0 statistical software was used to analyze the data. Results The blood loss, blood transfusion, operation time and length of stay in the observation group were significantly lower than those in the control group (P<0.05). ALT and AST were significantly lower in the observation group than in the control group on the 14th day after treatment. Significance (P < 0.05). There was no significant difference in FPG, 2 h PG, and Hb A1c levels before and after treatment in the observation group (P>0.05). After treatment, FPG and 2 h PG levels in the control group were higher than before treatment, and were higher than those in the observation group. The difference was statistically significant. Significance (P all < 0.05). Conclusions Radiofrequency ablation can significantly reduce the blood loss and blood transfusion in patients with small hepatocellular carcinoma, shorten the operation time and length of stay, make the recovery of liver function faster, and have no significant effect on blood glucose levels.