原发性大肝癌的射频治疗  

Radiofrequency ablation of large primary hepatic carcinoma

作　　者：向进见[1] 沈世强[1] 童仕伦[1] 韩亮[1] 

机构地区：[1]武汉大学人民医院普通外科,430060

出　　处：《临床外科杂志》2004年第4期229-231,共3页Journal of Clinical Surgery

摘　　要：目的　研究射频治疗对原发性大肝癌 (直径 >3cm)的效果及其并发症。方法　本院2 0 0 0年 8月～ 2 0 0 2年 6月间行射频治疗的 44例原发性大肝癌患者。 3 2例采用经皮肝穿刺射频治疗 ,12例行术中肿块射频治疗加门静脉、肝动脉分别置泵化疗。结果　 44例肝癌者一次治疗完全消融为 5 1.5 % ( 2 4/ 44 ) ,接近完全消融 ( 90 %～ 99% )为 3 0 .3 % ( 12 / 44 ) ,部分消融 ( 5 0 %～ 89% )为18.2 % ( 8/ 44 )。 1个月时AFP复常率 47.1% ( 16/ 3 4) ;术中肿块射频治疗发现新癌结节患者 4例 ;3 9例患者随访 6个月 ,9例患者复发 ;患者治疗后可出现发热、右侧胸腔积液、肝功能不全等并发症。结论　射频治疗对大肝癌患者是一种有效的、安全的方法。术中肿块射频治疗相对优于经皮肝穿刺射频治疗。对于肿瘤直径大于Objective To study local therapeutic efficacy and complications of radiofrequency ablation (RFA) in the treatment of large primary hepatic carcinoma lesions (diameter>3 cm).Methods 44 patients who had large primary hepatic carcinoma from 2000.8 to 2002.6 in ourhospital were collected.32 cases underwent percutaneous radiofrequency ablation (PRFA) and 12 introoperative radiofrequency ablation (IRFA).Results Complete necrosis was attained in 24 lesions (24/44),nearly complete (90%～99%) necrosis in 12 lesions (12/44) and partial (50%～89%) necrosis in the remaining 8 lesions (8/44).AFP was returned normal level in 16 lesions of 34 positive hepatic carcinoma after one month.New nodes were found in 4 cases during IRFA.Following 6 months after the first treatment of 39 cases,9 cases recurred in 44 patients.Pyrexia,right hydrothorax and liver dysfunction were observed in large primary hepatic carcinoma.Conclusion RFA appears to be an effective,safe and relatively simple procedure for the treatment of large primary hepatic carcinoma.IRFA has some advantages.Meanwhile,several times of the treatment and positive hepatic protection after procedure are needed for tumors when their diameter is larger than 10 cm.

关 键 词：原发性大肝癌 射频治疗 

分 类 号：R735.7[医药卫生—肿瘤]