超声引导射频消融治疗肝转移癌应用价值  

The Value of Ultrasound-guided Radio Frequency Ablation for Metastasic Liver Carcinoma

作　　者：武金玉[1] 李晓阳[1] 林淑芝[1] 禹宏[1] 徐爱哲[1] 

机构地区：[1]哈尔滨市第一医院,哈尔滨150010

出　　处：《中华腔镜外科杂志（电子版）》2010年第6期51-55,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨超声引导下射频消融（RFA）治疗肝转移癌适应症选择、治疗方案及疗效的应用价值。方法 36例82个病灶经临床及病理确诊并拟行RFA者进入本研究;肿瘤平均直径（3.8±1.2）cm,≥4cm肿瘤47.5%（39/82灶）,单发肿瘤30.5%（11例）。例行超声造影或增强CT检查,根据造影灌注特征及病灶数目、大小形态、浸润范围、位置、与周围结构关系等,确定RFA适应证,其中31例为常规超声引导下经皮射频消融治疗、3例为术中开腹后行射频消融治疗、2例为腹腔镜下射频消融治疗。均经1-3个月超声造影或增强CT随访评价疗效。结果 36例82个灶根据造影结果制定方案行RFA分期治疗及扩大消融治疗。肿瘤灭活率为95.1%（78/82灶）,局部复发率7.3%（6/82）,新生转移率38.8%（14/36例）。结论超声引导下射频消融治疗肝转移癌,可应用经皮、术中及腹腔镜下多种方式行消融治疗,超声及超声造影为肝转移癌适应证选择和治疗方案制定提供参考依据,从而有效提高疗效并降低复发率,是RFA治疗肝转移癌重要的辅助方法。Objective To investigate the value of ultrasound-guided radio frequency ablation（RFA）in selecting indications,treatment protocol and efficacy for metastasic liver carcinoma（MLC）.Methods There were 36 patients with 82 lesions diagnosed MLC with clinical and pathological in thepresent study,and those were prepare for RFA,average tumor size（3.8±1.2）cm,≥4 cm tumors47.5%（39/82 leisions）,single tumor 30.5%（11 leisions）.They were examined by contrastedenhanced ultrasound or enhanced CT,determed the indications for RFA on findings of the number,size,shape,infiltration,location and enhancing features of the lesions.Among the 36 patients,31 patientswere treated by conventional ultrasound-guided percutanrous RFA,3 patients were treated intraoperative,2 patients were treated in laparoscopic.They were confirmed by 1 to 3 months follow-up contrasted enhanced ultrasound orenhanced CT.Results 36 patients of 82 lesions were developed programs forexpanding lion of RFA ablation or stage treatment by results.Inactivation rate of tumor was 95.1%（78/82 lesions）,local recurrence rate was 7.3%（6/82 lesions）,and new transfer rate was 38.8%（14/36 lesions）.Conclusions Ultrasound-guided radio frequency ablation for metastasic livercarcinoma can be choosed by percutanrous,intraoperative and laparoscopic surgery.ultrasound andcontrast enhanced ultrasound provided a reference in indications and treatment options,which effectively improved theefficacy of treatment and induced the relapserate.They were important supplementary methods in RFA.

关 键 词：超声造影 肝转移癌 射频治疗 

分 类 号：R735.7[医药卫生—肿瘤]