集束电极射频毁损术治疗不能切除的大肝癌  

Treatment of unresectable large liver cancer by radiofrequency ablation with clustered electrodes

作　　者：梅方雄[1] 李荣[1] 叶永红[1] 高焱明[1] 

机构地区：[1]广东医学院附属湛江中心医院肝胆外科

出　　处：《中国微创外科杂志》2005年第2期111-112,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨集束电极射频毁损术治疗不能切除的原发性大肝癌的临床价值。方法　B超引导经皮穿刺 38例,术中穿刺 5例。治疗后复查发现肿瘤残存或复发者可重复治疗。　结果　43例 (肿瘤直径平均 7 3cm),行射频毁损术治疗62次,平均每次 6点。术前AFP>400μg/L者 56. 3% (18 /32)治疗后降至正常。术后CT检查 76. 7% (33 /43)肿瘤完全毁损。常见的并发症有发热、疼痛、肝功能受损,无严重并发症或与操作相关的死亡。1年存活 79. 3% (23 /29)。　结论　集束电极射频毁损术治疗不能切除的大肝癌,可使大范围的肿瘤发生热坏死,是一种安全有效的治疗方法,为无法切除的大肝癌开辟了一条新的治疗途径。Objective To evaluate the clinical significance of radiofrequency ablation (RFA) with clustered electrodes in the treatment of unresectable large primary liver cancer. Methods Under the guidance of ultrasonography, Percutaneous and intraoperative RFA was performed in 38 patients and 5 patients,respectively. Additional ablation could be conducted if residual tumor or recurrence was found after the primary treatment. Results A total of 62 times of RFA, with a mean of 6 foci every treatment, were completed in the 43 patients, in whom the mean diameter of tumor was 7 3 cm. AFP levels had decreased to normal in 18/32 patients (56 3%) whose preoperative AFP levels were above 400 μg/L. Postoperative CT examinations indicated that the tumor was completely ablated in 33/43 patients (76 7%). Frequent complications included fever, local pain, and liver impairment. No severe complications or treatment-related deaths were seen. The 1-year survival rate was 79 3% (23/29). Conclusions RFA with clustered electrodes in the treatment of unresectable large liver cancer can produce extensive coagulation necrosis of tumor, being a safe and effective therapeutic method. It is breaking fresh ground in the management of unresectable large

关 键 词：治疗后 不能切除 大肝癌 毁损术 集束电极射频 肿瘤 严重并发症 常见 复治 肝功能受损 

分 类 号：R735.705.4[医药卫生—肿瘤]