超声引导经皮双极射频消融治疗肝癌的局部疗效观察  

Local therapeutic efficacy of ultrasound-guided percutaneous bipolar radiofrequency ablation for liver cancer

作　　者：伯小皖 郑曙光[1,2] 徐辉雄[1,2] 郭乐杭[1,2] 孙丽萍[1,2] 卢峰[1,2] 刘琳娜[1,2] 刘畅[1,2] 

机构地区：[1]同济大学附属第十人民医院 [2]上海市第十人民医院超声医学科,上海200072

出　　处：《影像诊断与介入放射学》2014年第3期258-262,共5页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金(No:81371570;81301229;81301299);上海市卫生局重点项目(No:20114003);上海市人才发展基金(No:2012045)

摘　　要：目的：观察超声引导经皮双极射频消融治疗肝癌的局部疗效。方法选取我院2012年5月～2013年10月收治、以治愈性治疗为目的的24例肝癌患者32个病灶，对所有患者均采取超声引导下经皮双极射频消融进行治疗，术后1个月观察患者影像学（超声造影、增强CT或增强MRI）检查结果，以评价局部疗效，以后每3个月随访一次，以观察患者复发情况。结果病灶完全消融（CA）率96.9%（31/32），其中最大径＜3cm病灶CA率为100%（27/27），最大径≥3cm病灶CA率为80%（4/5）；原发性肝癌完全CA率95.7%（22/23），转移性肝癌CA率100%（9/9）。所有患者均未出现严重并发症及与手术相关的死亡。随访2～19个月，局部复发率为6.3%（2/32）远处复发率为33.3%（8/24）。结论超声引导下经皮双极射频消融治疗肝癌安全可靠、局部疗效确切，对小肝癌尤其明显。Objective To observe the local therapeutic efficacy of ultrasound-guided percutaneous bipolar radiofrequency ablation for liver cancer.Methods 24 patients with 32 liver tumor nodules who were referred to our hospital from May,2012 to October,2013.All patients were treated with ultrasound-guided percutaneous bipolar radiofrequency ablation with curative intention. We Observed the local therapeutic efficacy of all patients within one month after the treatment.The imageological examination （Contrast-enhanced ultrasound,contrast-enhanced Computed Tomography or contrast-enhanced magnetic Resonance Imaging） were used to decide the local therapeutic efficacy.We obeserved the recurrence of the tumors through the follow-up of every three months.Results Complete ablation（CA）was achieved in 96.9%（31/32）of tumor nodules.The CA rate was remarkably higher in nodules ≤3 cm（100%,27/27）than that in nodules 〉3 cm（80%,4/5）（P〈0.05）.CA rate was 95.7%（22/23）for primary liver cancers and 100%（9/9）for metastatic liver cancers.There was no mortality associated with bipolar radiofrequency ablation. Patients were followed-up from 2-19 months.The local recurrence rates were 6.3%（2/32）and the distant recurrence rates were 33.3%（8/24）.Conclusion Ultrasound-guided percutaneous bipolar radiofrequency ablation for liver cancer is a safe and effective method, especially for small liver cancers.

关 键 词：超声引导 双极射频消融 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]