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超声引导经皮射频消融治疗肝癌的研究
引用本文:Xie XY,Lü MD,Yin XY,Chen JW,Shen Q,Xu HX,Huang P,Huang JF.超声引导经皮射频消融治疗肝癌的研究[J].中华外科杂志,2003,41(1):23-26.
作者姓名:Xie XY  Lü MD  Yin XY  Chen JW  Shen Q  Xu HX  Huang P  Huang JF
作者单位:1. 510080,广州,中山医科大学附属第一医院超声科
2. 510080,广州,中山医科大学附属第一医院肝胆外科
摘    要:目的 探讨超声引导经皮射频消融 (PRFA)治疗肝癌的疗效及影响疗效的因素。方法 采用温控式多电极技术对 47例肝癌患者 6 7个结节行PRFA ,肿瘤直径 2 6± 1 1cm( 1 0~ 5 5cm)。 结果 肿瘤完全消融 (completedablation ,CA)率 :全组 80 6 % ,其中肿瘤≤ 3cm者 91 7% ,3 1~ 4 0cm者 75 0 % ,4cm以上者 14 3%。消融开始后 2min内达到 70℃的结节CA率显著高于 2min以上者 (P <0 0 5 ) ,治疗中维持温度达到 80℃以上者CA率也明显高于 70℃~ 80℃者 (P <0 0 1)。治疗后局部复发率 9 3% ( 5 / 5 4)。平均随访期间 11 3个月 ,远处复发 18例 ( 38 3% ) ,1年累计生存率82 1%。 结论 肿瘤大小、消融中局部组织的升温时间和维持的温度对PRFA的疗效有重要影响。

关 键 词:肝肿瘤  透热疗法  射频  超声引导
修稿时间:2002年9月18日

Application of ultrasound-guided percutaneous radiofrequency ablation in treatment of liver cancer
Xie Xiao-yan,Lü Ming-de,Yin Xiao-yu,Chen Jun-wei,Shen Quan,Xu Hui-xiong,Huang Pei,Huang Jie-fu.Application of ultrasound-guided percutaneous radiofrequency ablation in treatment of liver cancer[J].Chinese Journal of Surgery,2003,41(1):23-26.
Authors:Xie Xiao-yan  Lü Ming-de  Yin Xiao-yu  Chen Jun-wei  Shen Quan  Xu Hui-xiong  Huang Pei  Huang Jie-fu
Institution:Department of Medical Ultrasonics, First Affiliated Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou, 510080, China. xxy@gzsums.edu.cn
Abstract:OBJECTIVE: To investigate the therapeutic efficacy and its influencing factors of ultrasound-guided percutaneous radiofrequency ablation (PRFA) in the treatment of liver carcinoma. METHODS: With a temperature-controlled multi-electrode needle, ultrasound-guided PRFA was employed to treat forty-seven patients with 67 tumor nodules, with a diameter of 2.6 +/- 1.1 cm (1.0 - 5.5 cm). RESULTS: A complete ablation (CA) rate of 80.6% was achieved in the present series, with a CA rate of 91.7% in the tumors < or = 3 cm in diameter, 75.0% in tumors from 3.1 to 4.0 cm, and 14.3% in tumors > 4 cm. The CA rate was significantly greater in tumors with a temperature rising up to 70 degrees C within the initial 2 minutes at ablation as compared with that longer than 2 minutes (P < 0.05). A markedly higher CA rate was obtained in tumors with an ablation-maintaining temperature of over 80 degrees C than that between 70 degrees C and 80 degrees C (P < 0.01). All patients were followed up with a mean time of 11.3 months. The local recurrence rate was 9.3% (5/54), and 1-year survival rate was 82.1%. Eighteen patients (38.3%) had a distant recurrence. CONCLUSIONS: The tumor size, temperature-rising time and ablation-maintaining temperature represented the important factors affecting the therapeutic efficacy of PRFA.
Keywords:Liver neoplasms  Diathermy  Radiofrequency  Ultrasound-guidance
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