经皮局麻联合超声造影对困难肝癌射频消融治疗的可行性及安全性分析  

Radiofrequency ablation for liver cancer in difficult place under percutaneous local anesthesia combined with contrast enhanced ultrasonography

作　　者：高军喜[1] 谷昊[2] 王雅婷[1] 王颖鑫[1] 杨磊[1] 韩伟[1] 宋涛[1] Gao Junxi;Gu Hao;Wang Yating;Wang Yingxin;Yang Lei;Han Wei;Song Tao(Departmentof Ultrasound, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China;Endoscopic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China)

机构地区：[1]新疆医科大学第一附属医院腹部超声科,乌鲁木齐830011 [2]新疆医科大学第一附属医院腔镜外科,乌鲁木齐830011

出　　处：《中华普通外科杂志》2019年第7期572-575,共4页Chinese Journal of General Surgery

基　　金：新疆维吾尔自治区自然科学基金项目(2016D01C269).

摘　　要：目的探讨经皮局麻联合超声造影对困难肝癌进行射频消融治疗可行性及安全性。方法实验组45例(62个病灶)采用经皮、局麻联合超声造影及人工腹水辅助下进行射频消融,同期对照组40例(54个病灶)部分采用CT引导、部分采用腹腔镜及开腹后超声引导下射频消融,比较两组并发症及术后残留率及复发率差异。结果两组85例患者治疗中及治疗后4例发生较严重并发症,两组术中及术后疼痛评分及术中出血比较差异有统计学意义(P < 0. 05),对照组疼痛评分及出血程度均高于对照组,术后1个月两组病灶残留率、术后3、6个月两组治疗后复发率比较差异无统计学意义。结论经皮局麻联合超声造影并部分结合人工腹水对困难肝癌进行射频消融与传统方法比较并发症低,患者痛苦少。短期残留率及复发率无差异。Objective To explore the feasibility and safety of radiofrequency ablation for difficult access liver cancer under percutaneous local anesthesia combined with contrast-enhanced ultrasonography. Methods 45 patients ( 62 lesions) in the experimental group were treated by percutaneous, local anesthesia combined with contrast-enhanced ultrasound and in some cases with artificial ascites assisted by radiofrequency ablation vs control group of 40 patients (54 lesions) rec&ving radiofrequency ablation guided by CT or ultrasound through laparoscopy or open surgery. The complications, and postoperative residual and recurrence rates were compared between the two groups. Results Of the all patients, 4 cases suffered from severe complications. The pain scores and the blood loss were less significant in the experimental group. There was no significant difference in tumor residual rate between the two groups when evaluated on one month after the procedures, and in the recurrence rate after three and six months. Conclusion Radiofrequency ablation for difficult liver cancer by percutaneous local anesthesia combined with contrast- enhanced ultrasonography is less traumatic and less of complications compared to traditional method with a similar tumor residual rate and recurrence rate.

关 键 词：癌 肝细胞 导管消融术 

分 类 号：R735.7[医药卫生—肿瘤]