无水酒精注射与射频及射频综合治疗体积不等肝癌的疗效比较  

Curative Effects of Percutaneous Ethanol Injection,Radiofrequency Ablation and Combined Therapy with Radiofrequency Ablation for Different Size Hepatocellular Carcinoma

作　　者：智慧[1] 罗葆明[1] 文艳玲[1] 杨海云[1] 欧冰[1] 马健鸿[1] 

机构地区：[1]广东省广州市中山大学附属第二医院超声科,510120

出　　处：《实用全科医学》2007年第9期760-761,共2页Applied Journal Of General Practice

基　　金：广东省自然科学基金课题(编号:31710);广东省医学科研项目(编号:A2003203)

摘　　要：目的比较原发性肝癌无水酒精注射、射频及射频综合治疗的疗效。方法对临床确诊的73例共89个病灶(<3cm,Ⅰ组)行单纯瘤内无水酒精注射治疗;124例共161个病灶(<3cm,Ⅱ组)予射频消融治疗;25例共35个病灶(>3cm,Ⅲ组)给予单纯射频消融治疗;46例共62个病灶(>3cm,Ⅳ组)于射频消融治疗之前分别进行了肝动脉化疗栓塞或瘤内无水酒精注射治疗。结果Ⅰ组:术后1个月病灶完全坏死率以及术后1,2,3和5年生存率分别为76.4%、78.8%、60.4%、52.5%和33.3%;Ⅱ组分别为91.8%、93.9%、73.2%、63.5%和46.4%;Ⅲ组分别为22.9%、47.6%、42.9%和27.3%,5年仅1例存活;Ⅳ组分别为56.5%、68.6%、46.2%、36.8%和27.3%。结论小肝癌射频消融治疗效果优于单纯无水酒精注射治疗;对>3cm肝癌应采用综合治疗。Objective To compare the therapeutic response of percutaneous ethanol injection （PEI）, radiofrequency ablation （RFA） and combined therapy with RFA on hepatocellular carcinoma（HCC）. Methods Seventy - three patients confirmed by pathologic and/or clinic diagnosis with 89 nodules（ 〈 3 cm,group 1 ） were only treated by PEI. One hundred and twenty - four patients with 161 nodules（ 〈 3 cm,group 2） were only treated by RFA. Twenty-five patients with 35 nodules（ 〉 3 cm,group 3 ） were only treated by RFA. Forty-six patients with 62 nodules（ 〉 3 cm,group 4） were treated by combined therapy with RFA and transcatheter arterial chemo-embolization （TACE）/or PEI. Results The complete necrosis rate of the lesions and the 1 st-,2nd-, 3rd-,Sth-year survival rates were 76.4% ,78.8% ,60.4% ,52.5% and 33.3% respectively in Group 1, and 91.8% ,93.9%, 73.2% ,63.5% and 46.4% respectively in Group 2, and 22.9% ,47.6% ,42.9% and 27.3% , respectively and Only one patient was still alive after 5 years in Group 3 ,and 56.5% ,68.6% ,46.2% ,36.8% and 27.3% respectively in Group 4. Conclusions The therapeutic response of RFA on small HCC was better than PEI. The combined therapy with RFA and TACE/or PEI should be used in large HCC.

关 键 词：肝癌 射频消融 酒精注射 栓塞 疗效 

分 类 号：R735.7[医药卫生—肿瘤]