本文選題：肝癌 + 射頻消融�。� 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]比較射頻消融術(Radiofrequencyablation, RFA)與手術切除術治(Surgical resection,SR)米蘭標準下小肝癌的臨床有效性和安全性。[方法]利用計算機和人工檢索的方式檢索PubMed、The Cochrane Library、Embase、CNKI、維普期刊、萬方數(shù)據(jù)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM),全面搜集射頻消融術與手術切除治療米蘭標準下小肝癌的臨床對照研究。按照Cochrane協(xié)作網(wǎng)提供的方法用RevMan5.3軟件進行Meta分析[結果]一共檢索出11篇文獻,2274名患者納入此次研究,其中RFA組1160名,SR 組 1114。RFA 組與 SR 組 1、3 年總體生存率(OR,0.79 (95%CI,0.46to 1. 36) , Z 檢驗:P=0. 39, OR,0.72 (95%CI,0.50to1. 02),Z 檢驗:P=0. 06)無統(tǒng)計學差異(P0. 05),5年總體生存率RFA組低于SR組(OR, 0. 55 (95% CI,0.41 to 0.73),Z檢驗:P0.0001),差異有統(tǒng)計學意義(P0.05)。1年和5年無瘤生存率相比分別為(OR, 0. 78 (95% CI,0. 61 to 1. 00),Z檢驗:P=0. 05)。和(OR,0.47 (95% CI,0. 37 to 0. 61),Z 檢驗:P00001)。SR 組在 1、5 年無瘤生存率中比RFA組更高,差異有統(tǒng)計學意義。3年無瘤生存率(OR, 0. 74 (95%CI, 0.53 to 1.02),Z檢驗:P=0. 06)差異無統(tǒng)計學意義。RFA組比SR組的并發(fā)癥發(fā)生率低(OR,0.23 (95% CI, 0.11 to 0.52) , Z 檢驗:P=0.0003),安全性更高。[結論]RFA相較于SR有更少的并發(fā)癥,安全性(并發(fā)癥的發(fā)生率)更高。就短期療效(1、3年總體生存率及1、3年無瘤生存率)來說RFA與SR的治療效果相當,長期生存率(5年以后及更遠的總體生存率及無瘤生存率)而言SR療效是優(yōu)于RFA的。,SR術仍然是肝癌患者的首選治療方式
[Abstract]:[objective] to compare the clinical efficacy and safety of radiofrequency ablation (RFA) and Surgical resection (SR) in the treatment of small hepatocellular carcinoma (HCC). [methods] computer and manual search were used to retrieve the Cochrane Library Embase CNKI, Weip Journal, Wanfang data, Chinese Biomedical Literature Database (CBM), and to collect the clinical comparative study of radiofrequency ablation and surgical excision for small hepatocellular carcinoma (HCC) in Milan standard. According to the method provided by Cochrane Cooperative Network, Meta-analysis was performed with RevMan5.3 software. [results] A total of 11 articles were retrieved from 2274 patients who were included in the study. Among them, 1160 patients in SR group and 1114 in SR group and SR group had a 3-year overall survival rate (OR0.79 (95CI0.46to 1). 36), Z test: P0. 95 CI 0.50 to 1. 02) Z test. There was no statistical difference (P0. The 5-year overall survival rate in RFA group was lower than that in SR group (OR, 0. 55 (95% CI 0.41 to 0.73) Z test: P0.0001, the difference was statistically significant (P0.05). The 1-year and 5-year tumor-free survival rates were respectively (ORO, 0. 0001). 78 (95% CI). 61 to 1. 00) Z test. ) And (ORX) 0.47 (95% CI). 37 to 0. 61) the 5-year tumor-free survival rate in SR group was higher than that in RFA group, and the 3-year tumor-free survival rate was significantly higher in SR group than that in RFA group. 74 (95CI, 0.53 to 1.02). The incidence of complications in RFA group was lower than that in SR group (OR 0.23 (95% CI, 0.11 to 0.52), Z test was 0.0003), and the safety of RFA group was higher than that of SR group. [conclusion] RFA has fewer complications and higher safety than SR. In terms of short-term efficacy (1-, 3-year overall survival rate and 1-, 3-year tumor-free survival rate), RFA is comparable to SR. Long-term survival rate (overall survival and tumor-free survival after 5 years and beyond) SR is superior to RFA. SR is still the first choice for HCC patients.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.7

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