12例肝内邻近大血管肿瘤的射频消融治疗报道

目的观察射频消融（radiofrequency ablation,RFA）治疗位于肝内大血管旁肿瘤患者的安全性和疗效.方法通过对12例位于大血管旁行RFA治疗的肝癌患者观察,记录RFA治疗中、治疗后的不良反应及并发症情况,定期进行肝功、CT、AFP的随访观察,了解治疗后的复发、转移和生存情况.结果所有病人均平稳安全完成治疗,普通并发症和一般RFA治疗相似,没有出现严重的并发症,彩超及CT复查均未发现临近血管有明显损伤;增强CT复查一次RFA后肿瘤的完全坏死率为91.7%,APF术后全部降低,有1例乳腺癌肝转移病人在射频消融治疗3个月内肝脏其他部位发现新病灶,3～6个月内有1例出现肿瘤局部复发和1例出现其他肝叶转移,1例在1年内出现肿瘤肝脏其他部位转移.结论 RFA治疗位于肝内大血管旁这一特殊部位肿瘤有着较好的安全性和可靠性;但其长期疗效有待进一步随访.

Treatment of Liver Tumor nearby Major Vessel with Radiofrequency Ablation-12 cases reports

Objective To assess the safety and effect of radiofrequency ablation(RFA)in treating liver tumor which near major vessel in order to provide data for the rational use in clinics.Methods Radiofrequency ablation was practiced clinically for 12 patients with liver cancer which near major vessel.CT scan was performed and the AFP was observed regularly.Complications after RFA were observed and survival time of patients followed up.Results No death was observed.RFA were performed uneventfully in all patients.The major vessel near the tumor was unaltered.Complete necrosis of tumor was seen in 11 cases(91.7%).Of six cases of positive AFP,AFP level became negative in 4,decreased obviously in 2 within 1-3 months followed RFA;New breast tumor metastasis was observed in one case within 3 months,local recurrence was observed in one case and new metastasis was found in one casa within 3-6 months,new metastasis was observed in one case within 6-12 months.Conclusion It is safe and feasibile to perform radiofrequency ablation near the major vessel,but the long-term outcome should be observed.