肝脏局灶性结节性增生超声引导下热消融疗效分析  

Analysis of clinical efficacy of ultrasound-guided thermal ablation for focal nodular hyperplasia of the liver

作　　者：陈文娟[1] 贺需旗[2] 余萱 李凯[2] 曾庆劲[2] Chen Wenjuan;He Xuqi;Yu Xuan;Li Kai;Zeng Qingjin(Department of Ultrasound,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China;Department of Ultrasound,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]广东省中山市中医院超声科,528400 [2]中山大学附属第三医院超声科,广州510630

出　　处：《中华肝脏外科手术学电子杂志》2022年第2期188-192,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家自然科学基金(81827802);国家重点研发计划项目(2017YFC0112000)。

摘　　要：目的探讨超声引导下热消融治疗肝脏局灶性结节性增生(FNH)的安全性及有效性。方法回顾性分析2008年11月至2021年5月在中山大学附属第三医院行超声引导下经皮热消融治疗的26例肝脏FNH患者临床资料。其中男14例,女12例;年龄21~63岁,中位年龄32岁。患者均签署知情同意书,符合医学伦理学规定。26例共35个病灶,其中直径≤3 cm的结节28个,直径3~6 cm 7个。26个病灶位于肝右叶,9个位于肝左叶。根据患者病灶的位置、大小等采用相应的消融方式,观察术中、术后情况及完全消融率。结果采用微波消融21例,射频消融5例。单次消融时间为2~8 min,中位时间5 min。5例采用人工胸腔积液或腹腔积液辅助,2例采用腹腔镜辅助。消融后即时超声造影评估提示所有病灶均消融完全,术后1个月超声或MRI评估提示病灶完全消融率为100%(35/35)。术后未发生出血、腹腔感染、肝衰竭等严重并发症。术后住院时间2~9 d。术后中位随访时间10(2~30)个月,均未见肿瘤复发。结论超声引导下热消融治疗肝脏FNH是安全、有效的微创治疗方法,选择合适病例和采用合理辅助手段可以减少并发症发生,提高消融成功率。Objective To evaluate the safety and efficacy of ultrasound-guided thermal ablation in the treatment of focal nodular hyperplasia(FNH)of the liver.Methods Clinical data of 26 patients with FNH of the liver treated with ultrasound-guided percutaneous thermal ablation in the Third Affiliated Hospital of Sun Yat-sen University from November 2008 to May 2021 were retrospectively analyzed.Among them,14 patients were male and 12 female,aged from 21 to 63 years,with a median age of 32 years.The informed consents of all patients were obtained and the local ethical committee approval was received.35 lesions were detected in 26 cases,including 28 lesions with a diameter of≤3 cm and 7 lesions with a diameter of 3-6 cm.26 lesions were located in the right lobe,and 9 in the left lobe.According to the location and size of lesions,corresponding ablation methods were adopted.Intraoperative and postoperative conditions and the complete ablation rate were observed.Results Microwave ablation was performed in 21 patients and radiofrequency ablation in 5 cases.The single ablation time was 2-8 min,with a median time of 5 min.5 patients were assisted by artificial pleural effusion or peritoneal effusion,and 2 cases by laparoscopy.Real-time contrast enhanced ultrasound after ablation demonstrated that all lesions were completely ablated.Ultrasound or MRI at postoperative 1 month showed that the complete ablation rate of the lesions was 100%(35/35).No severe complications,such as bleeding,abdominal infection or liver failure,occurred after operation.The length of postoperative hospital stay was 2-9 d.The median postoperative follow-up was 10(2-30)months,and no tumor recurrence was observed.Conclusions Ultrasound-guided thermal ablation is a safe and efficacious minimally invasive treatment for FNH of the liver.Choosing suitable cases and using auxiliary methods can lower the risk of complications and improve the success rate of ablation.

关 键 词：消融技术 局限性结节状增生 超声检查 治疗结果 

分 类 号：R73[医药卫生—肿瘤]