深度冷冻治疗肝癌57例体会  

CRYOSURGERY FOR LIVER CANCER:EXPERIENCE IN TREATING 57 PATIENTS

作　　者：魏学[1] 芮静安[1] 王少斌[1] 陈曙光[1] 李爱英[1] 张宁[1] 

机构地区：[1]邮电总医院肝癌研究所,北京100032

出　　处：《肝胆外科杂志》1998年第5期282-283,共2页Journal of Hepatobiliary Surgery

摘　　要：目的为增加不能手术切除肝癌病人的治疗机会，完善肝癌冷冻治疗术。方法总结1994年6月至1997年12月我肝癌研究所采用LCS-2000型冷冻机治疗原发性肝癌51例，继发性肝癌6例的治疗体会。所有病例均为晚期肝癌。冷冻术中B超引导下确定肿瘤及冷冻针位置并监测冷冻范围。冷冻深度达-198℃，冰球超过肿瘤组织1cm。结果术中27例未输血。术后均有发烧，平均恢复正常时间9天。术后SGPT较术前显著升高（P＜0．01），平均恢复术前水平时间9．4天。BUN手术前后无显著区别。术后继发出血3例，肝肾功能不全各1例。随访1年生存率61．5％，二年生存率38．2％。结论深度冷冻术是治疗肝癌的一种有效方法。继发出血及肝肾功能不全是其主要并发症。Objective To enhance chance of treatment for the patient with unresectable liver cancer and to make cryosurgery forliver cancer perfect. Methods Cryogenic surgical LCS 2000 has been used for the treatment of 51 patients with primary liver cancer, and 6 patients with secondary liver cancer from June 1994 to December 1997. There were 9 on clinical stageⅡ, 22 on Ⅲ, 12 onⅣa, and 8 on Ⅳ b. There were 44 patients with cirrhosis in primary liver cancer. After the lesions have been lacated, the cryoprobe isinserted into or around the lesion and is anchored in place by repidly lowing the probe temperature to-198℃ to create an ice ballthat will encompass the lesion about 1 cm margin of normal liver tissue with guiding of intraoperative ultrasound. Cryosurgery wasPerformed averagely 3. 2 times on each patient and lasted for an average of 13. 2 minutes for each time. Results 27 patients havenot been transplanted with blood during operation. Fever occurred in all patients after operation and spends averagely 9 days returning to normal level. The level of serum SGPT is higher than that before operation, and it spends averagely 9. 4 days returning tonormal level. 3 patients suffered from bleeding, 2 patients liver and renal function failure respectively. 1-year actual survival ratewas approximately 61. 5% and 2-year actual survival rate was 38. 2%. Conclutlon Cryosurgery is a effective therapy for unresectable primary hepatic cancer. Bleeding and function failure of hepatic or renal are main complications.

关 键 词：肝癌 冷冻术 治疗 

分 类 号：R735.705[医药卫生—肿瘤]