经皮射频消融联合无水酒精注射治疗结直肠癌肝转移疗效观察  

Clinical Study on the treatment of colorectal liver metastasis using PRFA in combination with PEI

作　　者：崔彦[1] 董满库[1] 李晓鸥[1] 周立艳[1] 吉敏[1] 王平[1] 刘子沛[1] 张宏文[1] 李成林[1] 

机构地区：[1]解放军第三0六医院普通外科总装备部普通外科中心,北京100101

出　　处：《中国医师杂志》2006年第12期1590-1592,共3页Journal of Chinese Physician

摘　　要：目的评价经皮射频消融（PRFA）联合无水酒精注射（PEI）治疗结直肠癌肝转移的疗效。方法B超引导下PRFA联合PEI治疗结直肠癌肝转移37例61个病灶，肿瘤直径1．5～7．8cm。应用RF2000射频仪和10电极LeVeen针。病灶〉2．5cm者予分层多点叠合射频消融。对1～2cm的小肿瘤选择Chiba针注射无水酒精，而对〉3cm者应用Quadra—Fuse多位穿刺注射针。随访观察病灶影像形态表现、血清癌胚抗原（CEA）变化、病人病情缓解率与生存时间。结果PRFA＋PEI经过均顺利，并发症2例（5．4％），腹壁穿刺针道转移和电极片灼伤皮肤各1例，无相关死亡。随访率97．3％（36／37），随访期17～65月，缓解率（CR＋PR）为94．4％。患者1、2、3年生存率分别为97．2％、75．0％和52．8％。结论PRFA联合PEI是治疗结直肠癌肝转移的有效微创局部治疗方案。Objective To assess the local treatment efficacy of percutaneous radiofrequency ablation （PRFA） in combination with pereutaneous ethanol injection （PEI） therapy protocol for liver metastases in patients with colorectal cancer. Methods From February 2000 to February 2004, total of 61 liver metastatic lesions （ 1, 5 ～7.8 cm） from 37 colorectal cancer patients were ablated by using RF-2000 generator and 10-needle LeVeen electrode pereutaneously guided by B-ultrasound. Tumors larger than 2. 5 cm in diameter were treated by multiple overlapping radiofrequency ablations encompassing the entire lesion as well as a rim of normal liver tissue （ approximately 1.0 cm）. PEI was performed additionally, The Chiba needle and Quadra-Fuse multi-pronged injection needle were used for tumors ranged 1 - 2 cm and for those larger than 3 cm respectively. Results The procedures were performed successfully in all patients, The post-PRFA/PEI complication rate was 5.4%. The follow-up rate was 97. 3% （36/37）. Thirteen patients achieved a complete response （CR）, and 21 achieved a partial response （PR）. The effective rate （CR ＋PR） was 94,4%. The patients＇survival rates were 97.2% at 1 year, 75.0% at 2 years, and 52. 8% at 3 years respectively. Conclusion The results of this study suggest that the treatment protocol of PRFA in combination with PEI was an effective mini-invasive local ablation therapy, which was part of the comprehensive management of the colorectal liver metastases.

关 键 词：导管消融术 乙醇/治疗应用 结直肠肿瘤/治疗 肝肿瘤/治疗/继发性 

分 类 号：R735.3[医药卫生—肿瘤]