经皮冷循环射频消融治疗T_(1a)期肾细胞癌  

Percutaneous cool-tip radiofrequency ablation for T_(1a) renal cell carcinoma

作　　者：王光春[1] 朱崴[1] 王波[1] 耿江[1] 黄建华[1] 夏盛强[1] 罗明[1] 车建平[1] 鄢阳[1] 康黎[1] 彭波[1] 许云飞[1] 郑军华[1] 

机构地区：[1]同济大学附属第十人民医院泌尿外科,上海200072

出　　处：《上海医学》2013年第7期609-611,共3页Shanghai Medical Journal

基　　金：国家自然科学基金(30972984);上海市市级医院新兴前沿技术联合攻关项目(SHDC12010104);上海市卫生局新百人计划(XBR2011021)

摘　　要：目的探讨经皮冷循环射频消融治疗T1a期肾细胞癌的安全性和疗效。方法初诊为T1a期单发肾细胞癌的患者15例,肿瘤位于左肾6例、右肾9例。术前常规行肾脏增强CT检查明确肿瘤的大小和位置,肿瘤直径1.1~3.9cm,平均直径为（2.7±1.1）cm。所有患者均行经皮冷循环射频消融治疗。术后定期随访,比较手术前与手术后第1天、第1周、第1个月、第3个月时,患者的血红蛋白和血清肌酐水平、红细胞沉降率、患侧肾小球滤过率,并行肾脏增强CT检查观察病灶情况。结果 15例患者均成功接受经皮冷循环射频消融治疗,无1例发生严重手术并发症,均于术后第2天出院。与术前比较,术后各时间的血红蛋白和血清肌酐水平、红细胞沉降率、患侧肾小球滤过率的差异均无统计学意义（P值均〉0.05）。术后第1周,肾脏增强CT检查见原肿瘤区域呈低密度影;术后第1个月,肾脏增强CT检查见病灶完全消融13例、消融不全2例,完全消融率为13/15;术后第3个月,肾脏增强CT检查见病灶完全坏死14例、部分坏死1例,完全消融率为14/15。术后随访2~22个月,中位随访时间为9.3个月,15例患者均生存,无1例发生局部或远处复发。结论经皮冷循环射频消融治疗T1a期肾细胞癌是安全、有效的。Objective To investigate the safety and therapeutic effects of percutaneous cool-tip radiofrequency ablation for T1arenal cell carcinoma.Methods Fifteen patients was diagnosed as T1asingle renal cell carcinoma and received percutaneous cool-tip radiofrequency ablation.Six tumors were located in the left kidney and nine in the right side.Enhanced CT scanning was performed before surgery to identify tumor size and location.The average tumor diameter was（2.7±1.1）cm（range,1.1-3.9cm）.During postoperative follow-up period,all patients received enhanced CT scanning.Hemoglobin（Hb）,serum creatinine（sCr）,erythrocyte sedimentation rate（ESR）and glomerular filtration rate（GFR）were detected before surgery,on one day,one week,one month and three months after surgery.Results Percutaneous cool-tip radiofrequency ablation was successfully performed in the 15cases.There were no severe complications.All the patients were discharged on day 2postoperatively.Compared with preoperative values,there were no significant differences in Hb,sCr,ESR and GFR on one day,one week,one month and three months after surgery（all P0.05）.One week after operation,low density shadow was found in the tumor region.One month after operation,complete ablation was achieved in 13cases and partial ablation in 2cases,with an ablation rate of 13/15.Three months after operation,14lesions were completely necrotic and only one lesion was partially necrotic,with an ablation rate of 13/15. During the follow-up period of 2—22months（mean,9.3months）,all the 15patients survived and no recurrence or metastasis was found.Conclusion Percutaneous cool-tip radiofrequency ablation is a safe,effective and minimally invasive treatment for T1arenal cell carcinoma.

关 键 词：射频消融 肾癌 冷循环电极 疗效 

分 类 号：R737.11[医药卫生—肿瘤]