腹腔镜超声引导下射频消融术治疗小肝癌的相关性研究  

Correlation study of laparoscopic-assisted ultrasonic-guided radiofrequency ablation in the treatment of small hepatoma

作　　者：谢光军[1] 郭云虎[1] 漆兴美 张励[1] 徐敬修 徐东楚 杨明[1] 蒋永军[1] 洪玉[2] 谢金敏[3] 

机构地区：[1]淮安市淮阴医院,江苏淮安223300 [2]新疆医科大学基础医学院生物学教研室 [3]中国人民解放军第四七四医院

出　　处：《腹腔镜外科杂志》2014年第1期25-27,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜射频消融术（laparoscopic radiofrequency ablation，LRFA）治疗小肝癌（2cm〈直径≤5cm）的临床应用价值。方法：采用LRFA治疗5例（7个瘤体）小肝癌患者，肿瘤位于肝脏Ⅱ、V、Ⅷ段，Child-Pugh肝功能分级为ChildA级或B级，术中超声准确定位后行LRFA；治疗后3周复查超声造影及甲胎蛋白，以判断其疗效。结果：术后5例患者均未出现复发或远处转移，且术中LRFA超过肿瘤范围1．0～2．5cm，甲胎蛋白下降显著。结论：LRFA对小肝癌的治疗效果确切、可靠，对瘤体位于较大胆道系统尤其合并门静脉高压症患者安全、有效，可作为治疗小肝癌的选择方法之一。Objective： To explore the value of the radiofrequency ablation in the treatment of small hepatoma （2 cm 〈 diameter ≤5 cm） with laparoscope assisting and ultrasonic guidance. Methods：Five patients who suffered from small hepatoma with a total of 7 tumors were treated by laparoscopic radiofrequency ablation （LRFA）. The tumors （in Child-Pugh Class A or B） rose from Ⅱ , V and VM sections. Ultrasonic visualization in the 5 patients was carried out before the LRFA and the ultrasound and value of AFP were re- checked respectively 3 weeks after LRFA to assess treatment efficacy. Results：LRFA was successfully performed in the 5 patients and no case recurred. No distal metastasis was found. The diameter of the ambit of the ablation was 1.0-2.5 cm longer than the prior, and the value of AFP obviously fell off. Conclusions：The treatment of small hepatoma with LRFA is a safe, feasible, reliable and minimally invasive procedure which is strongly recommended for hepatomas located near the larger biliary system, especially for the patients suffer- ing from complication of cirrhosis and portal hypertension. This procedure is an alternative for treatment of small hematoma.

关 键 词：肝肿瘤 射频消融术 腹腔镜检查 

分 类 号：R735.7[医药卫生—肿瘤]