射频消融在治疗肝癌合并肝动脉-门静脉分流中的应用价值  

Therapeutic Value of Radiofrequency Ablation for Treatment of Hepatocellular Carcinoma with Arterioportal Shunts

作　　者：沈新颖[1,2] 张彦舫[1,2] 孔健[1,2] 窦永充[1,2] 李勇[1,2] 蔡进中[1,2] 何凡[1,2] 陈旭东[1,2] 

机构地区：[1]暨南大学第二临床学院 [2]深圳市人民医院介入科,广东深圳518020

出　　处：《肿瘤防治研究》2012年第9期1120-1124,共5页Cancer Research on Prevention and Treatment

摘　　要：目的评价射频消融(RFA)对肝癌合并肝动脉-门静脉分流(APS)的治疗价值。方法对34例肝癌合并APS患者,针对APS和肿瘤行射频消融治疗,2周后行肝增强CT或MRI扫描并行TACE治疗。比较肿瘤消融、坏死效果及APS分流道封闭情况。结果射频消融术后15例中央型APS完全消失4例,分流减少8例,3例无明显变化;10例肝段型APS,有3例术后APS消失,5例好转,2例无变化;周围型9例,术后消失5例,好转4例。38个消融病灶中,完全坏死11个病灶,14个病灶坏死面积超过50%,坏死50%以下有8个病灶,4个病灶RFA术后强化面积无变化,1个病灶进展。术后随访3～12月,3、6、9、12月累计生存率分别为100%、94.1%、82.4%、73.5%。结论射频消融联合TACE是治疗肝癌合并肝动脉-门静脉分流的安全有效的方法。Objective To evaluate the therapeutic efficacy of radiofrequency ablation for the treatment of hepatocellular carcinoma（HCC）with arterioportal shunts（APS）.Methods Thirty-four cases of hepatocellular carcinoma with APS patients,treatment for APS and tumor radiofrequency ablation enhanced CT or MRI scan 2 weeks ofter the liver parallel TACE treatment.Tumor ablation,necrosis effect APS shunt closed situation.All the 34HCC patients with APS were treated with radiofrequency ablation（RFA）.The ablation lesions and APS occlusion were detect by enhanced CT or MRI two weeks later and then TACE was carried out.Results The 15central-type APS were occluded completely in 4cases occluded partially in 8cases and not occluded in 3cases.The 10hepaticsegment-type APS were occluded completely in 3cases,occluded partially in 5cases and not occluded in 2cases.In the 9peripheral-type APS patients,complete occlusion occurred in 5patients and partial occlusion in 4patients.Thirty-eight lesion sites were treated by RFA.Completely necrosis occurred in 11tumors,the necrosis more than 50%area occurred in 14tumorss and less than 50%in 8tumors.No change and progressive deterioration occurred respectively in 4tumors and 1tumor.With a follow-up of 3～12 months,and survival rate of 6months,9months,12months and 18months was 100%,94.1%,82.4% and 73.5%,respectively.Conclusion Radiofrequency ablation combined with Transcatheter arterial chemoemblization was an effective and safe therapy.

关 键 词：肝动脉-门静脉分流 射频消融 肝细胞肝癌 经皮动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]