CT引导下人工腹水结合三维可视化系统辅助射频消治疗难消融复发性肝癌  

CT-guided artificial ascites combined with three-dimensional visualization system-assisted radiofrequency ablation for refractory recurrent hepatocellular carcinoma

作　　者：黄职妹[1] 宁额尔敦巴格 李慧 马榕 林青雨 郑舒淇 黄金华[1] HUANG Zhimei;NING Eerdunbage;LI Hui;MA Rong;LIN Qingyu;ZHENG Shuqi;HUANG Jinhua(Department of Minimally-Invasive Intervention,Sun Yat-sen University Cancer Center,Guangdong Province 510060,China)

机构地区：[1]中山大学肿瘤防治中心微创介入科,广州510060 [2]海南省海口市人民医院消化内科 [3]中山大学中山医学院 [4]中山大学医学院

出　　处：《介入放射学杂志》2022年第4期387-393,共7页Journal of Interventional Radiology

摘　　要：目的 评价CT引导下人工腹水结合三维可视化系统(3DVAPS)辅助射频消融治疗难消融的复发性肝癌的临床疗效和安全性。方法 回顾性分析中山大学肿瘤防治中心2015年3月至2020年12月177例复发性肝细胞癌患者的CT引导下射频消融的资料,其中257个病灶位于有挑战性的消融困难部位。肿瘤预后包括消融相关并发症、人工腹水技术成功率、完全消融技术成功率。结果 177例患者的腹腔注入0.9%氯化钠溶液100~3 000 mL,平均853.71 mL,其中169例(95.48%)成功诱导人工腹水。术后复查腹部CT可见腹腔注水全部消失,其中仅有94例(53.11%)术中出现轻微并发症,均未出现严重并发症。术后162例患者消融边缘充分,增强扫描示消融区无强化。CT引导下人工腹水结合3DVAPS辅助射频消融手术的完全消融技术成功率为91.53%(162/177)。结论 CT引导下人工腹水结合3DVAPS辅助射频消融治疗难消融复发性肝癌是一种安全、有效的治疗方法。Objective To evaluate the clinical efficacy and safety of CT-guided artificial ascites combined with three-dimensional visualization system-assisted(3DVAPS-assisted) radiofrequency ablation(RFA)in the treatment of refractory recurrent hepatocellular carcinoma(HCC).Methods The clinical data of a total of 177 patients with recurrent HCC,who received CT-guided RFA at the Sun Yat-sen University Cancer Center of China between March 2015 and December 2020,were retrospectively analyzed.A total of 257 lesions were located at certain special sites which were difficult for RFA manipulation.The RFA-related complications,the success rate of artificial ascites technique,and the success rate of complete ablation technique were documented.Results Peritoneal cavity injection of normal saline 100-3 000 ml(mean of 853.71ml)was performed in all 177 patients,and artificial ascites was successfully produced in 169 patients(95.48%).Postoperative abdominal CT scan showed that all the injected solution in peritoneal cavity completely vanished away.Mild complication was observed only in 94 patients(53.11%) and no serious complications occurred.In162 patients,the ablated extent was sufficient and no enhancement area was demonstrated on postoperative contrast-enhanced CT scan.The technical success rate of CT-guided artificial ascites combined with 3DVAPSassisted RFA was 91.53%(162/177).Conclusion For refractory recurrent HCC,CT-guided artificial ascites combined with 3DVAPS-assisted RFA is a safe and effective therapy.(J Intervent Radiol,2022,31:387-393)

关 键 词：肝癌 射频消融 困难部位 人工腹水 三维可视化系统 技术成功率 

分 类 号：R735.7[医药卫生—肿瘤]