4种方法引导射频消融治疗肝癌537例报告  

Four guide Methods of Radiofrequency Ablation in Treating Small Liver Tumors:Report of 537 Cases

作　　者：黎鹏[1] 梁惠宏[1] 陈敏山[1] 林小军[1] 张耀军[1] 徐立[1] 张亚奇[1] 李锦清[1] 

机构地区：[1]中山大学肿瘤防治中心肝胆外科,510060

出　　处：《实用癌症杂志》2007年第5期495-498,共4页The Practical Journal of Cancer

摘　　要：目的总结经皮B超、经皮CT引导、腹腔镜直视下引导和开腹术中引导4种方法引导射频消融治疗小肝癌的经验。方法537例小肝癌按引导方式的不同分为4组,分别采用上述4种方法之一引导射频治疗。其中经皮B超引导512例,经皮CT引导8例,腹腔镜直视下引导9例,开腹术中引导8例。结果手术所需时间最短为经皮B超引导(55.26±18.57)min,最长为开腹术中引导(213.57±13.48)min。术后平均住院时间最短为经皮B超引导(4.44±2.53)d和经皮CT引导(4.20±1.64)d,最长为开腹术中引导(11.14±4.49)d。术后严重并发症发生率以开腹术中引导最高(25.0%)。4种引导方法的死亡率和完全消融率相近。结论4种引导方法引导射频消融治疗肝癌各有优缺点及其适用情况,其中,经皮B超引导创伤小,恢复快,操作简单,是首选的引导方法。当因各种原因不能使用经皮B超引导时,应根据实际情况选用其他3种引导方法,尽量以最小的创伤取得最好的效果。Objective To summarize our initial experience of different guide methods of radiofrequency ablation （RFA） in the treatment of liver tumors. Methods 537 patients were treated with radiofrequency ablation guided by percutanous ultrasound,percutanous CT scan, laparoscopy, or surgery. Of the 537 patients, 512 were treated by percutanous ultrasound guided RFA, 8 by CT guided RFA ,9 by laparoscopy guided RFA, and 8 by surgery guided RFA. Results Percutanous ultrasound guided RFA had the shortest operation time（55.26 ± 18.57）min, whereas surgery guided RFA had the longest time（213.57 ± 13.48 ） min. Percutanous ultrasound and CT scan guided RFA had the shortest hospitalization time, being （4.44 ±2.53 ） d and （4.20 ±1.64） d ,respectively ,and surgery guided RFA had the longest hospitalization time （11.14± 4.49 ）d. Complications were most common in patients treated with surgery guided RFA （25.0%）. The mortality and complete ablation rate of the four methods are similar. Conclusion Percutanous ultrasound guided RFA is recommended for most patients. If the percutanous ultrasound guided RFA could not be performed due to the special conditions,other methods may still be choiced.

关 键 词：肝癌 微创 治疗 射频消融 引导方法 

分 类 号：R735.7[医药卫生—肿瘤]