射频消融治疗难治性细菌性肝脓肿  

Efficacy of radiofrequency ablation in treatment of complicated pyogenic liver abscess

作　　者：柯山[1] 王劭宏[1] 孔新亮 高君[1] 丁雪梅[1] 王强 孔健[1] 许力 孙文兵[1] Ke Shan;Wang Shaohong;Kong Xinliang;Gao Jun;Ding Xuemei;Wang Qiang;Kong Jian;Xu Li;Sun Wenbing(Department of Hepatobiliary-Pancreatic-Splenic Surgery,West Campus,Beijing Chao-yang Hospital Affiliated to Capital Medical University,Beijiag 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院西院肝胆胰脾外科,100043 [2]山东省日照市中心医院肝胆胰脾外科

出　　处：《中华肝胆外科杂志》2018年第8期505-509,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金（81572957,81502650）;北京市石景山区医学重点学科建设项目（20130001）;北京市医管局培育计划项目（PX2017014）;北京朝阳医院京西培育计划（JXPY201605）

摘　　要：目的探讨射频消融（RFA）治疗复杂性细菌性肝脓肿（PLA）的临床价值。方法回顾性分析2010年8月-2018年1月首都医科大学附属北京朝阳医院西院及山东省日照市中心医院以RFA为主要手段治疗的20例复杂性PLA患者的临床资料。RFA采用腹腔镜联合术中超声及CT引导完成。术后评价技术成功率、有效率和安全性，并定期随访。结果技术成功率为100％，中位操作时间为45min。20例患者均经一次RFA治疗，获得临床治愈。其中1例患者RFA治疗后，病灶由“多房”分隔状态转为“单房”液化坏死状态，经后续经皮经肝穿刺置管引流治疗最终获得治愈。所有患者均未出现严重并发症。结论对于抗生素联合介入治疗疗效不佳的难治性PLA患者，RFA有可能成为一种安全、有效的替代治疗方式。Objective To evaluate the efficacy of radiofrequency ablation （RFA） in treatment of complicated pyogenic liver abscess （PLA）. Methods A retrospective analysis was conducted on 20 patients with complicated PLA treated from August 2010 to January 2018 in the West Campus of Beijing Chao-yang Hospital which is Affiliated to the Capital Medical University and Rizhao Central Hospital of Shandong Province. These patients were treated with RFA based treatment modalities using CT-guided or laparoscopy combined with Ultrasound-guided RFA. The successful rate, efficacious rate and safety of RFA were respectively analyzed. Routine follow-up was carried out after treatment. Results The successful rate of RFA was 100%. The median operation time was 45 minutes. All the 20 patients were cured by one session of RFA. The multilocular lesion in one patient was converted to a unilocular lesion after one session of RFA. The patient was then cured by percutaneous hepatic abscess drainage. No serious complications were observed. Conclusions RFA was safe and efficacious. It should be considered as an alternative treatment for patients with complicated PLA who were not responsive to, or not applicable to antibiotics treatment and radiological intervention.

关 键 词：肝脓肿 射频消融 治疗 

分 类 号：R657.33[医药卫生—外科学]