The safety and the efficacy of computed tomography guided percutaneous radiofrequency ablation of osteoid osteoma

ObjectiveThe aim of this study was to investigate the efficacy and safety of Computed Tomography (CT) guided percutaneous Radiofrequency Ablation (RFA) in the treatment of osteoid osteoma (OO).MethodsA total of 116 patients (82 male and 34 female patients; mean age of 17.7 years; age range 13-months-42 years) who had 118 CT guided RFA treatment between June 2015 and November 2018 (42 moths) with the diagnosis of OO were included in this study. All the patients had pre-procedural CT examinations. The clinical and technical success and the safety of the treatment were evaluated by assessing the clinical pain symptoms, complication rates and recovery of posture and gait.ResultsAll the patients had a favorable immediate relief of the known pain caused by osteoid osteoma in 24 h after the procedure. Only in two patients (15-years-old boy with OO in right femoral neck and a 12 years old boy with OO in femur diaphysis) pain relapse was occurred in 3 months and 12 months after RFA and a second RFA was performed. During follow-up they had no pain. The technical success and efficacy-rates of the procedure were recorded as 100% and 98% respectively in this study. No significant complication was observed during treatment or recovery period. Seven minor complications were noted which were successfully treated.ConclusionThe rapid relief of pain symptoms, low relapse rate and low complication rates demonstrate the efficacy and safety of RFA therapy. RFA is an out-patient procedure that patients can be mobilized immediately after the procedure. RFA can be safely used as a first choice of treatment method in OO therapy.Level of evidenceLevel IV, therapeutic study.     

Percutaneous core excision and radiofrequency thermo-coagulation for the ablation of osteoid osteoma of the spine

Percutaneous radiofrequency ablation is the treatment of choice for osteoid osteoma of the appendicular skeleton. However, difficulties in localizing the lesion in the spine and its proximity to neural elements have yet to make it the prevalent treatment for spine. This study assesses the safety and effectiveness of two percutaneous techniques for ablating osteoid osteoma of the spine. Seven patients were treated between 1998 and 2005. Four patients underwent percutaneous radiofrequency coagulation. The lesions were located at the articular processes of L3 and L4, the lamina of L3 and in the head of the 11th rib. Three patients with lesions in close proximity to neural structures (pedicle of T9, the posterolateral inferior aspect of L3 vertebral body and the inferior articular process of C5) were subjected to percutaneous core excision. Mean follow-up was 4.2 ± 1.6 years. Three out of four patients who underwent radiofrequency ablation had an immediate and sustained response. One patient with a lesion in the head of the rib failed to respond. The three patients in the group of pecutaneous core excisional biopsy demonstrated immediate relief of pain. However, one patient experienced relapse of symptoms 6 months after transpedicular core excision. CT scan suggested partial targeting of the lesion that corroborated with histologic examination revealing only reactive tissue. Subsequent percutaneous core excision was successful. Therefore, the overall success rate was 85.7%. Mean VAS improved dramatically from 9 ± 1 to 2 ± 1 after surgery (P < 0.05). No neurological or other complications were encountered. This study indicates that radiofrequency ablation of spinal osteoid osteomas is safe and reasonably effective when an intact cortical shell separates the nidus from the neural elements. Percutaneous core excision can obviate the risk of thermal damage for lesions located in close proximity to the neural elements. Effectiveness of treatment can also be evaluated by CT scan and histological examination. Difficulties in targeting the nidus can lead to treatment failure. The minimal morbidity and the effectiveness of these minimally invasive procedures make them a valid alternative in the treatment of spinal osteoid osteoma.     

Basic and clinical studies of percutaneous radiofrequency ablation of osteoid osteoma using a standard electrosurgical generator

 For percutaneous radiofrequency ablation of osteoid osteoma for pain management, we used a standard electrosurgical generator instead of the radiofrequency generator system. First, we used the standard electrosurgical generator to determine the diameter of the coagulated area of normal femurs and humeruses of dogs under general anesthesia and to detect damage to normal tissue around the bone. We then used a standard electrosurgical generator to perform percutaneous radiofrequency ablation of the osteoid osteoma. All three patients were almost pain-free within the first 24 h after the procedure, and they were discharged the day after the operation, being hospitalized for only 2 days. We thus confirmed that percutaneous radiofrequency ablation using a standard electrosurgical generator produced results similar to those achieved with the radiofrequency generator system. Received: August 19, 2002 / Accepted: January 11, 2003 RID="*" ID="*" Offprint requests to: A. Takeda     

Percutaneous CT-guided radiofrequency ablation of osteoid osteoma: Potential Pitfalls and complications and how to avoid them

Targeted cannulation of the nidus and subsequent thermal ablation is the basis of CT-guided radiofrequency ablation (RFA) of osteoid osteoma, which is considered nowadays as the treatment of choice. The majority of complications during this procedure are due to thermal injury of adjacent structures. Specific measures as per the anatomical location of osteoid osteoma can avoid the majority of complications. This article enlists the possible complications and their necessary precautions and remedies to avoid these complications during CT-guided radiofrequency ablation of osteoid osteoma.     

High-frequency radio-wave ablation of osteoid osteoma in the lumbar spine

The authors report on the first known application in the spine of percutaneous ablation of osteoid osteoma using radio-frequency waves. The technique involves a CT-guided biopsy of the lesion followed by introduction of a 1-mm probe connected to a radio-frequency lesion generator. The procedure was performed on an outpatient basis and the patient experienced immediate relief of his symptoms. No evidence of recurrence was demonstrated 16 months later. The techniqe described may become the procedure of choice in the surgical treatment of osteoid osteoma, as it minimises surgical trauma and post-operative pain. Longer follow-ups are required to monitor the incidence of recurrence. Received: 31 January 1998 Revised: 16 April 1998 Accepted: 24 April 1998     

Correlation of 3-T MRI and CT findings with patient symptoms and treatment outcome in radiofrequency ablation of osteoid osteoma

ObjectiveThe aim of this prospective study was to evaluate pre- and post-treatment MRI and CT findings of osteoid osteoma (OO) patients treated with radiofrequency thermo-ablation (RFTA) and to compare these findings with visual analog scale (VAS) scores.MethodsSixteen patients (4 females and 12 males; mean age of 18.87 ± 8.75 years (range: 8–37)) with OO were examined with CT and MRI, at baseline and at an average of 3 months following the procedure. On pre- and post-procedural CT and MRIs, OO-related findings were recorded. Treatment success was evaluated with VAS scores.ResultsBaseline VAS scores were 8 or 9 and follow-up scores were 0 or 1, indicating no early recurrences.Nidus diameters decreased significantly after the procedure (p = 0.027, p = 0.002, and p = 0.002; and p = 0.001, p = 0.001, p = 0.001 for AP, ML and CC nidus diameters for CT and MRI, respectively).The mean nidus volume were significantly decreased after the procedure (p = 0.001, for CT and MRI).On post-procedural images, cortical thickening, the signal intensity and contrast enhancement of the nidus and the extent of periostitis were significantly decreased (p = 0.019, p = 0.001, p = 0.001 and p = 0.034, respectively). There was no significant change in nidus calcification, perinidal cortical and intramedullary sclerosis, periosteal reaction, bone deformity, bone marrow and soft tissue edema, joint effusion and synovitis after the procedure (p = 0.253, p = 0.062, p = 0.245, p = 1, p = 1, p = 0.429, p = 0.371, p = 0.625, p = 1).ConclusionAlthough the changes in imaging findings may be helpful in early follow-up of OO patients treated with RFTA, these changes alone cannot be used with accuracy in predicting treatment response.Level of EvidenceLevel IV, Therapeutic Study.     

Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation?

Osteoid osteoma (OO) of the cervical spine is frequently located close to the vertebral artery, spinal cord, or nerve roots and complete surgical excision is sometimes difficult by a limited approach and more extended surgery can require spinal fusion. Percutaneous radiofrequency coagulation (PRC) has demonstrated efficacy in the treatment of OO of the pelvis and limbs however, its role in the cervical spine is still nuclear. The Authors present a series of nine cases of OO of the cervical spine, six treated with surgical excision and three with PRC. No neurological or vascular complications occurred in both series. One case of the surgical series had only partial relief of persistent pain for 1 year due to incomplete excision, but is doing well 4 years after surgery. All the other surgical cases had complete relief of symptoms immediately after surgery and are symptom-free 3–10 years later. Two cases of PRC had complete relief of symptoms 24–48 h after surgery and are symptom-free 2 and 3 years later. One case of recurrent OO after surgery and treated with PRC with a reduced dose improved only, and still requires anti-inflammatory drugs 2 years after the procedure. Our still limited experience suggests that PRC can be safely performed in local anaesthesia with the patient awake, enabling to check for signs and symptoms of possible neurological injury. PRC can substitute extensive posterior approaches and reconstructions for OO of the posterior arch and joint pillar. Read at the 21st “Annual Meeting of the Clinical Spine Research Society—European Section”, Rome, 16–17 June 2005. Authors’ declaration: This study complies with the current laws of the country in which it was performed inclusive of ethics approval.     

48例儿童骨样骨瘤的诊断与治疗分析

[目的]探讨小儿骨样骨瘤的临床特点及治疗方法.[方法]对48例小儿骨样骨瘤的临床特点、X线特点及治疗方法进行回顾性分析.[结果]本组病例均经手术治疗,术后无复发,病变部位疼痛、跛行、脊柱侧凸症状均消失.无植骨反应,无病理性骨折.[结论]根据小儿骨样骨瘤的临床特点、患病部位疼痛及X线可见典型的瘤巢,诊断并不困难.因本病痛苦大,确诊后应早期手术治疗.     

射频消融联合无水乙醇注射治疗肝癌协同效果的实验研究

目的 研究不同方式的射频消融(RFA)与无水乙醇(PEI)联合应用对正常兔肝脏的消融效果.方法 采用24只活体新两兰大白兔正常肝脏进行研究.分为4组,每组6只.A组为RFA后PEI组:1 cm单极射频针射频3 min+局部注射PEI 1.5ml;B组为PEI后RFA组:局部注射PEI 1.5 ml+局部1 cm单极射频针射频3 min;C组为RFA组:局部1 cm单极射频针射频3 min;D组为PEI组:局部注射PEI 1.5 ml.观察各组RFA术中的电阻、电流及单位消融体积能耗,行肝脏增强CT扫描分析各组消融灶大小、形态、体积、类圆率的情况.结果 B组消融长径和短径[分别为(24.1±4.4)mm和(21.4±4.0) mm]显著大于C组[分别为(12.4±1.6)mm和(11.1±1.4)mm]、D组[分别为(7.7±2.3)mm和(5.1±1.5)mm] (P＜0.01).在高径和消融体积上,B组[分别为(20.3±4.9) mm3和(5879±2607) mm3]显著大于A组[分别为(14.8±2.7)mm3和(3130±1250) mm3]、C组[分别为(10.7±1.6)mm3和(767±173)mm3]、D组[分别为(6.7±1.O)mm3和(146±83)mm3](P＜0.01).B组产生的消融灶类圆率最高,两两比较各组类圆率差异无统计学意义(P＞0.05).B组RFA术中电阻显著高于A组及C组(P＜0.05),B组RFA术中电流显著低于A 组及C组(P＜0.05).单位消融体积能耗A组、B组显著低于C组(P＜0.01).结论 PEI后RFA 组产生的消融体积明显大于RFA后PEI组、RFA组、PEI组;PEI后RFA组单位消融体积能耗最低;PEI后RFA组产生的消融灶类圆率最高.     

实时低剂量CT定位与超声定位建立经皮肾通道治疗复杂性肾结石的疗效比较

目的对比实时低剂量CT定位与超声定位建立经皮肾通道治疗复杂性肾结石的效果。 方法回顾我院2014年1月至2019年1月100例复杂性肾结石患者,分成两组,每组各50例,分别采用实时低剂量CT定位与超声定位穿刺建立经皮肾通道后行经皮肾镜碎石取石术。 结果两组患者均采用单通道取石,低剂量CT定位组所有患者均成功建立经皮肾通道,一期结石清除率为90%（45/50）,无一例出现大出血、胸腹腔主要脏器损伤等并发症;超声定位穿刺组其中1例建立经皮肾通道过程中因损伤肾静脉中止手术,一期结石清除率为72%（36/50）。 结论相对于超声定位穿刺,实时低剂量CT定位穿刺可更安全有效、快速地建立理想的取石通道,一期结石清除率更高,并发症更少,是安全可行、有效的经皮肾穿刺定位方法。     

原发性小肝癌射频消融与无水乙醇注射治疗对比研究

目的探讨射频消融(RFA)和经皮穿刺无水乙醇注射治疗(PEIT)治疗原发性小细胞肝癌(SHCC)患者的最佳适应证。方法对127例SHCC进行了RFA和PEIT,其中RFA组81例共97个病灶,PEIT组46例共59个病灶。比较患者RFA及PEIT 1、2、3、4、5年生存率和并发症,统计两组患者的医疗费用。结果两组患者术后均无严重并发症;RFA组术后1、2、3、4、5年生存率分别为91.3%、76.4%、62.8%、51.7%和44.4%;PEIT组病患者术后1、2、3、4、5年生存率分别为78.0%、60.0%、47.8%、37.5%和33.3%;RFA组患者平均治疗费用明显高于PEIT组。结论对于SHCC,RFA疗效优于PEIT;对于位于肝包膜下、大血管分支旁、血供丰富的SHCC,以PEIT为宜;PEIT费用低廉,患者依从性较好。     

经皮与开腹射频治疗肝癌的合理选择

目的：探讨射频（RFA）治疗肝癌不同途径的合理选用。方法：41例肝癌病人分为2组进行经皮射频（PRFA）治疗和开腹射频（IRFA）治疗,并对结果进行比较。结果：PRFA治疗18例病人共32个肿瘤结节,IRFA治疗23例病人共43个结节,PRFA和IRFA并发症率分别为33．3％和4．3％（P＜0．05）,随访平均10个月,PRFA组7个病灶复发（4个病人）,复发率21．9％（7／32）,而IRFA组仅1个结节复发,复发率2．3％（1／43,P＜0．025）,结论：RFA治疗肝癌途径的选用应根据病应位置,结节的大小和肝硬化程度等综合考虑而定,IRFA并发症少,治疗彻底,效果优于PRFA。     

射频消融联合经皮椎体成形术治疗脊柱转移瘤的疗效分析

目的 :观察射频消融联合经皮椎体成形术治疗脊柱转移瘤的临床疗效。方法 :回顾性分析2012年10月~2014年3月收治的55例脊柱溶骨性转移瘤患者的临床资料,其中28例行经皮椎体成形术(PVP组),27例行射频消融联合经皮椎体成形术(PVP+RFA组)。PVP组中男20例,女7例,年龄47.0±8.5岁,PVP+RFA组中男19例,女9例,年龄49.0±7.6岁。采用疼痛视觉模拟评分(visual analogue scale,VAS)评估患者疼痛情况,卡氏功能状态评分(Karnofsky,KPS)评价患者功能状态,观察两组患者骨水泥外渗情况及术后肿瘤复发率,并应用Kaplan-Meier法对全部患者进行生存分析。结果:随访6~18个月,PVP组11.68±3.29个月,PVP+RFA组12.19±3.33个月。PVP组VAS评分从术前的7.86±0.85分降至3.07±0.90分,PVP+RFA组从术前的7.67±0.96分降至2.96±0.94分,两组术后与术前比较均有统计学差异,疼痛明显缓解(P0.05);术前和术后6个月时两组VAS评分均无显著性差异(P0.05)。两组术后KPS评分较术前均有所提高,两组术后比较无统计学差异(P0.05)。PVP组骨水泥外渗率为42.86%,PVP+RFA组为11.11%;PVP组肿瘤复发率为32.14%,PVP+RFA组为7.41%,两组骨水泥外渗率及术后肿瘤复发率均有统计学差异(P0.05)。PVP组术后中位生存时间为12个月,PVP+RFA组为13个月,两组术后生存率比较无显著性差异(P0.05)。结论:PVP+RFA治疗脊柱溶骨性转移瘤可取得与PVP相似的临床疗效,并能有效减少骨水泥外渗及术后早期肿瘤进展。     

射频消融与经皮无水乙醇注射治疗小肝癌临床效果比较的系统评价

目的 评价射频消融(RFA)及经皮无水乙醇注射(PEI)在小肝癌治疗中的价值.方法 计算机检索MEDLINE(1966-2009)、EMBASE(1966-2009)、中国生物医学文献数据库(CBMdisc,1978-2009)、Cochrane图书馆、循证医学评价(Ovid版)和Cancerlit(1993-2009)等数据库,截止日期2009年6月30日,文献语种不限.纳入比较RFA与PEI治疗小肝癌的随机对照试验和非随机对照试验,对文献质量进行评估,统计分析采用RevMan4.2版软件.结果 纳入4个随机对照试验和1个非随机对照试验比较了RFA和PEI治疗小肝癌,Meta分析结果 表明:RFA与PEI治疗小肝癌后肿瘤完全坏死率、3年生存率、1、3年无瘤生存率和1、3年局部复发率比较,有统计学差异(P＜0.05);两种治疗方法 的1年生存率和引起主要并发症比较,无统计学差异(P＞0.05).结论 RFA治疗小肝癌的总体疗效优于PEI,而这种优势可能主要体现在肿瘤大于2 cm小肝癌的治疗;两种方法 均副作用小,安全可靠.

Abstract：

Objective To evaluate the value of radiofrequency ablation and Percutaneous Ethanol Injection in the treatment of small hepatocellular carcinoma (HCC). Methods We searched MED-LINE (1966-2009), EMBASE (1966-2009), CBMdisc (1978-2009), The Cochrane Library, Evidence Base Medicine Reviews (Ovid Edition), and Cancerlit (1993-2009). Date of last search: 30Jun 2009. There were no restrictions in language. Randomized controlled trials (RCTs) and nonRCTs (NRCT) were both included in this study, and the quality of each study included was assessed.Meta-analysis was performed using RevMan 4.2 software. Results Four RCTs and one NRCT met the inclusion criteria on RFA versus PEI in the treatment of small HCCs. Meta-analysis showed the following: complete tumor response rate, 3-year survival rate, 1-, 3-year tumor-free survival rates and 1-, 3-year local recurrence rates showed statistically significant difference in the RFA group than the PEI group(P＜0.05). The 1-year survival rate and the main complications of the two groups of patients were similar and they were not significantly different (P＞0. 055). Conclusions The results show that RFA resulted in better clinical outcomes than PEI in the treatment of small HCC larger than 2 cm, and no difference small HCC of 2 cm or less. The two modalities were safe and there were vey few adverse effects of the treatments.     

超声检查技术对于射频消融治疗肝癌的疗效评价

目的探讨超声检查技术评价射频消融治疗肝癌疗效的意义. 方法超声引导下对49例66个肝癌病灶行多弹头射频消融治疗,超声检查病灶术前术后的大小及回声、血流信号及频谱等作为评价该术疗效的超声监测指标,以CT作对照检查,观察术前术后AFP或CEA下降幅度. 结果术后1个月超声检查,其中42例59个病灶(89.4%)瘤体内可见"爪状"不均质高回声改变覆盖整个瘤体,其内未检出血流信号,此后瘤体逐渐缩小或不增大,回声趋于等回声改变,结合AFP或CEA值明显下降或降至正常水平,提示术后疗效良好;另7例7个病灶(10.6%)瘤体内部分回声未改变,其内检出动脉血流信号,AFP或CEA值下降不明显,提示第一次射频消融治疗不彻底,需要进行第二次追加治疗.术后1个月复查CT显示9例9个病灶有强化,其中7例7个病灶与超声检查提示一致.与CT检查对照分析,超声检查对病灶内血流检出的敏感性为55.6%(5/9),特异性为96.5%(55/57),准确性为90.9%(60/66). 结论超声检查技术亦可作为评价射频消融治疗肝癌疗效的一种有效手段.     

超声引导经皮无水酒精注射增效射频消融治疗肝癌的近期疗效

目的 探讨超声引导行PEI增效RFA治疗肝癌的近期疗效.方法 回顾性分析2010年6月至2011年6月第四军医大学西京医院收治的71例肝癌患者的临床资料.根据治疗方法将患者分为RFA组(25例)和联合组(46例).RFA组根据肿瘤大小,在超声引导下先将RFA电极置于肿瘤内部消融;联合组则是在超声引导下先向瘤内根据肿瘤大小缓慢注入95％的无水酒精,再迅速行RFA.术后2周超声造影检查评估两组患者肿瘤坏死体积大小,分析联合组术中RFA能量、酒精注射量与肿瘤消融体积之间的关系,观察两组治疗效果.率的比较采用x2检验,组间分析采用两样本的t检验及Pearson等级相关分析.结果 RFA组平均消融体积为(22±17) cm3,明显小于联合组的(55±44) cm3,两组比较,差异有统计学意义(t =3.85,P＜0.05).联合组中,酒精注射量越多肿瘤消融体积越大且呈正相关(r=0.615,t=5.86,P＜0.05);酒精注射量越多效能越低呈负相关(r=-0.709,t =-7.52,P ＜0.05).RFA能量越大肿瘤消融体积越大且呈正相关(r =0.884,t=14.13,P＜0.05);RFA能量越大效能也越低,但差异无统计学意义(r=-0.225,t=-1.72,P ＞0.05).推导出酒精注射量的方程式:Y =2.526X-2.693[Y为酒精注射量(ml),X为肿瘤直径(cm)].联合组3例患者在术中出现一过性疼痛,面部潮红,心率加快,经对症处理后,术中生命体征平稳.两组患者术后转氨酶均有不同程度升高,术后2周复查转氨酶均恢复正常.两组患者均未发生肝破裂出血、肠穿孔、胆汁漏及肿瘤种植等严重并发症.两组患者术后AFP值均明显下降,RFA组80％(20/25)的患者完全转为阴性,联合组85％(39/46)的患者完全转为阴性,两组比较,差异无统计学意义(x2 =0.42,P ＞0.05).结论 RFA治疗前行PEI可以增加消融范围,降低RFA效能,提高治疗效果.     

超声引导下经皮穿刺射频消融治疗甲状腺良性肿瘤的临床效果探讨

目的 探讨超声引导下射频消融治疗甲状腺良性肿瘤的临床效果.方法 超声引导下对129例甲状腺良性肿瘤患者共计149枚结节行射频消融治疗,随访观察结节的大小的变化情况及并发症的发生情况.采用配对设计t检验,计算结节的缩小率.结果 术后3个月和6个月门诊复查超声随访,129例患者结节的最长径及体积较治疗前不同程度缩小(P＜0.05),6例患者术中及术后有疼痛症状,停止消融后疼痛症状缓解;2例患者术后出现皮肤血肿,给予对症治疗后痊愈.未见皮肤灼伤、食管穿孔、气管损伤、声音嘶哑、饮水呛咳等并发症.结论 超声引导下经皮穿刺射频消融治疗甲状腺良性肿瘤效果显著,并发症少、安全性高、微创美观,值得进一步推广.     

肝裸区肝细胞癌经皮射频消融治疗的疗效和安全性

目的 探讨CT引导下经皮射频消融(percutaneous radiofrequency ablation,PRFA)治疗肝裸区肝细胞癌(hepatocellular carcinoma in the bare area,HCCBA)的疗效和安全性.方法 回顾性总结作者在2000年4月至2009年6月间收治的肝细胞癌(hepatocellular carcinoma,HCC)病人的临床资料,共有26例早期HCCBA病人接受了CT引导下PRFA治疗,作为HCCBA组;在右肝非裸区HCC病人中,以癌灶距肝包膜、胆囊和第一肝门主要分支的距离≥1.0 cm为条件,纳入26例作为对照组.两组病人的年龄、性别、基础肝病原因、肝功能分级、癌灶直径等方面的差异无统计学差异(P>0.05).癌灶残留采用PRFA后1个月增强CT和(或)甲胎蛋白(alpha-fetoprotein,AFP)追踪判定,将完全消融至局部肿瘤复发的间隔时间作为无瘤生存时间.用t检验比较癌灶直径,用MannWhitney U检验比较年龄、肝病原因、肝功能分级、AFP水平和穿刺次数等指标,用χ2检验比较完全消融率和局部无瘤生存率等指标.结果 两组术后并发症、穿刺次数和完全消融率无统计学差异(P>0.05).HCCBA组1年、3年和5年局部无瘤生存率分别为88.5%、46.2%和19.2%,对照组分别为92.3%、53.8%和15.4%,两组间亦无统计学差异(P>0.05).结论 CT引导下PRFA治疗HCCBA是安全和有效的,可以作为治疗方案之一.     

原发性肝癌射频消融后综合征的临床观察

目的研究原发性肝癌（HCC）经皮射频消融术（RFA）后出现消融后综合征的发生率，分析其发生的原因。方法2002年7月至2006年4月，37例HCC采用经皮RFA技术进行治疗。治疗前后分别行实验室及影像学检查。观察治疗后出现的各种临床症状及持续时间。结果37例均顺利完成RFA治疗。32．4％（12／37）病人出现消融后迟发性症状。其中发热12例、寒战1例、全身不适7例、消融部位疼痛9例、恶心5例、呕吐2例、呃逆2例。治疗后3d症状最明显，均在对症处理后14d内消失。消融后症状的发生与肿瘤体积、消融区体积、射频治疗时间及血清转氨酶（AST、ALT）水平呈明显相关性（P〈0．01）。肿瘤体积〈50cm^3（直径4．5cm）共19例，均未发生消融后综合征；肿瘤体积〉50cm^3共18例，66．7％（12／18）病人发生消融后综合征。结论HCC经皮RFA治疗后，约1／3病人可发生消融后综合征，其发生率与病灶大小相关，对症处理后2周内可自行消失。