射频消融辅助肝切除治疗原发性肝癌的研究  

Radiofrequency ablation assisted liver resection for hepatocellular carcinoma

作　　者：范瑞芳[1] 张超[1] 肖毅[1] 胡鹏[1] 袁克文[1] 雍召生[1] 李红梅[1] 许淑梅[1] 

机构地区：[1]兰州军区兰州总医院肝胆外科,甘肃兰州730050

出　　处：《西北国防医学杂志》2012年第6期621-623,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省自然科学研究基金计划资助项目(0803RJZA061)

摘　　要：目的:评价射频消融(RFA)辅助肝切除术治疗原发性肝癌的可行性、安全性及疗效。方法:25例原发性肝癌在全麻下行肝切除术,肝断面采用RFA进行辅助治疗,共治疗27个肿瘤,平均最大肿瘤直径(5.4±1.8)cm。结果:25例均顺利完成RFA辅助肝切除术。平均射频治疗时间(30.5±5.8)min,术后创面平均出血量(124.6±45.5)ml。未出现严重并发症。随访13～62个月(平均31个月),1例肿瘤切除边缘复发,6例发现肝内新病灶,2例肺转移,1例腰椎转移。再次采用经皮RFA治疗3例,肝动脉化学栓塞(TACE)治疗4例,8例死于肿瘤复发或肝功能衰竭。结论:RFA辅助肝切除术治疗原发性肝癌安全可行,可有效进行肝断面止血、降低肿瘤局部复发率。Objective：To evaluate the feasibility,safety and efficacy of hepatectomy combined with radiofrequency ablation（RFA） therapy for patients with hepatocellular carcinoma（HCC）.Methods： A total of 25 HCC patients with 27 tumors,with a maximum tumor diameter of 5.4±1.8 cm,were submitted to hepatectomy under general anesthesia,and adjunctive RFA therapy for the hepatic tissue of resection surface was performed following hepatectomy.Results： RFA assisted liver resection was successfully performed in the 25 patients.The mean RFA time was 30.5±5.8 min,and the mean postoperative blood loss was 124.6±45.5 ml.No severe complication was observed in all patients.During a median follow-up period of 31 months（range,13-62 months）,recurrent liver tumors on the resection margin were found in 1 patient,new hepatic malignant nodules in 6,pulmonary metastases in 2,and lumbar vertebrae metastasis in 1.Three patients received percutaneous RFA therapy again,and 4 patients underwent transcatheter arterial chemoembolization（TACE）.Eight patients died from tumor recurrence or liver failure.Conclusion： RFA assisted liver resection is a feasible,safe and effective treatment modality for HCC patients,which could possess satisfactory hemostatic property on the hepatic resection surface and decrease local recurrence rate of HCC after surgery.

关 键 词：肝细胞癌 射频消融术 肝切除术 复发 

分 类 号：R735.7[医药卫生—肿瘤]