氩氦刀冷冻消融治疗肝癌的临床疗效与安全性观察  

Observation on the Clinical Efficacy and Safety of Argon-Helium Cryoablation in the Treatment of Hepatic Carcinoma

作　　者：徐稳深[1] XU Wenshen(Department of General Surgery, the People ＇s Hospital of Boluo County, Huizhou 516100, China)

机构地区：[1]广东省博罗县人民医院普通外科,广东惠州516100

出　　处：《临床医学工程》2018年第4期405-406,共2页Clinical Medicine & Engineering

基　　金：惠州市科技局科研项目(项目编号:2012C108)

摘　　要：目的观察分析氩氦刀冷冻消融治疗肝癌的临床疗效与安全性。方法选取2012年1月至2015年12月间我院收治的行CT引导下氩氦刀冷冻消融术的32例肝癌患者为研究对象,记录患者的临床疗效、手术前后肝功能指标及并发症发生情况。结果术后22例患者的30个瘤体完全毁损,10例患者的13个瘤体部分毁损,瘤体完全毁损率为69.8%。瘤体完全毁损患者的肿瘤直径为1.9~7.4 cm,平均(5.5±0.9)cm;瘤体部分毁损患者的肿瘤直径为5.0~14.5 cm,平均(7.1±1.8)cm;肿瘤直径比较,差异有统计学意义(P<0.05)。术后1 d的丙氨酸转氨酶(ALT)、总胆红素(TBIL)水平高于术前,术后1周的ALT、TBIL水平低于术后1 d,术后2周的TBIL、ALT、ALB水平低于术后1 d,术后2周的ALT水平低于术后1周,差异有统计学意义(P<0.05)。32例患者中,发生肝功能损伤19例(59.4%),发热17例(53.1%),术后上腹部疼痛14例(43.8%),恶心呕吐11例(34.4%),Ⅱ度冻伤2例(6.3%),腹腔出血1例(3.1%),术后予以对症支持治疗后缓解,恢复至正常。结论氩氦刀冷冻消融治疗肝癌具有较好的临床疗效,但会造成一定程度的肝功能损伤和并发症,术后护肝与并发症防治非常重要。Objective To observe and analyze the clinical efficacy and safety of argon-helium cryoablation in the treatment of hepatic carcinoma. Methods From January 2012 to December 2015, 32 cases of patients with hepatic carcinoma who received argon-helium cryoablation under CT guidance in our hospital were selected as research objects. The clinical efficacy, preoperative and postoperative liver function indicators and complications were recorded. Results After operation, 30 turnors in 22 patients were completely destroyed, and 13 tumors in 10 patients were partially destroyed; The complete destruction rate of tumor was 69.8%. The tumor diameter of patients with complete tumor destruction was 1.9 - 7.4 cm, with an average of （5.5 ± 0.9） cm; The tumor diameter of patients with partial tumor destruction was 5.0 - 14.5 cm, with an average of （7.1 ± 1.8） em; The difference in tumor diameter was statistically significant （P〈0.05）. 1 d after operation, the alanine aminotransferase （ALT） and total bilirubin （TBIL） levels were higher than those before operation; 1 week after operation, the ALT and TBIL levels were lower than those at 1 d after operation; 2 weeks after operation, the levels of TBIL, ALT and ALB were lower than those at 1 d after operation; 2 weeks after operation, the level of ALT was lower than that at 1 week after operation; All the differences were statistically significant （P 〈0.05）. Among 32 patients, 19 cases （59.4%） had liver injury, 17 cases （53.1%） had fever, 14 cases （43.8%） had postoperative abdominal pain, 11 cases （34.4%） had nausea and vomiting, 2 cases （6.3%） had degree 11 frostbite, and 1 case （3.1%） had abdominal hemorrhage; After postoperative symptomatic treatment, the complications were relieved and recovered to normal. Conclusions Argon-helium cryoablation for the treatment of hepatic carcinoma has good clinical efficacy, but it can cause liver damage and complications, so postoperative liver protection and prevention of complications are v

关 键 词：肝癌 氩氦刀冷冻消融 临床疗效 肝功能 并发症 

分 类 号：R735.7[医药卫生—肿瘤]