集束电极射频肝癌原位灭活治疗的临床研究  

A clinical study on radio frequency ablation for the treatment of hepatic carcinoma

作　　者：吴金生[1] 褚延魁[1] 马庆久[1] 

机构地区：[1]第四军医大学唐都医院普外科,西安710038

出　　处：《中华普通外科杂志》2001年第4期214-215,共2页Chinese Journal of General Surgery

摘　　要：目的　研究射频 (Radiofrequency ,RF)技术肝癌原位灭活治疗的方法及疗效。方法在B型超声引导下将中空金属钛多极穿刺针经皮直接穿刺置入癌灶中心 ,分点一次或多次对癌体进行射频热毁损治疗。射频输出功率由 10W每隔 1min增加 10W ,加到 90W ,治疗时间设定为 15min。术后观察患者的甲胎蛋白 (a fetoprotein ,AFP)、B型超声 (癌体大小、回声、血流 )、计算机X线断层摄影术 (computeredtomography ,CT)图像及病理学变化。结果　本组甲胎蛋白 (AFP)高于正常者 (15 3例 )射频治疗 1周后复查 119/ 15 3(77 8% )下降为正常 ;14～ 2 8d和经过第 2次治疗后 144 / 15 3(94 1% )下降为正常 ;B型超声和CT图像上表现为癌灶无增大、缩小和液化 ,多普勒超声观察癌灶内无血流信号 ;术后病理学复查示治疗区为坏死组织伴血管血栓形成 ,142例患者术前伴疼痛 ,治疗后 12 1/ 142(85 2 % )疼痛消失 ,2 1/ 142 (14 8% )疼痛缓解。本组术后出现腹水 2 6 / 180 (14 4% )、一次性黄疸16 / 180 (8 9% )。结论　射频原位灭活是创伤小、安全。Objective To evaluate the results and feasibility of US guided radio frequency(RF) ablation for the treatment of primary or secondary liver tumors.Method 180 patients with liver tumor were treated with percutaneous ultrasound guided RF ablation.RF was applied by a frequency at 10?W with an increase of 10?W every other minute until 90?W for a total of 15 minutes,using single or multi puncture method.After RF treatment,the α fetoprotein (AFP) level was examined,the ultrasonograph,computered tomography(CT),biopsy were performed.[WT5”HZ]Results In those with abnormal pretreatment AFP level,1 week after RF treatment AFP returned to normal in 119/153(77 8%)patients;2 4 weeks later or after the second treatment AFP drops to normal in 144/153(94 1%) patients.Tumors failed to grow or shrank in size,some underwent liquefaction on CT and ultrasound follow up.The biopsy results of the treated lessions showed necrosis accompanied with microvessel thrombosis.Abdominal pain disappeared or relieved in 121/142(85 2%) patients.Ascites and temporary jaundice occured in 26/180(14 4%), and 16/180(8 9%) patients, respectively.Conclusion RF ablation is a mini invasive,safe,effective treatment for primary and secondary liver tumor.

关 键 词：肝细胞癌 放射肿瘤学 集束电极射频技术 原位灭活治疗 

分 类 号：R735.7[医药卫生—肿瘤] R730.55[医药卫生—临床医学]