腹腔镜联合经皮超声射频消融治疗肝细胞肝癌的疗效探讨

目的:探讨腹腔镜联合经皮超声射频消融术治疗肝癌的临床应用价值。方法:2011年5月至2015年10月为56例肝癌患者行腹腔镜下联合经皮超声射频消融术,记录术后肝功能、甲胎蛋白、生命体征及1个月后影像学检查结果。结果:56例患者、108个病灶均完成射频消融治疗,术后无针道出血、肝功能衰竭及邻近脏器损伤等严重并发症发生,102个病灶消融满意,6个病灶周围有残存,2个病灶在超声造影指引下予以再次消融,4个病灶在CT引导下再次消融,再次消融效果满意。结论:腹腔镜联合经皮超声射频消融治疗特殊部位的肝癌具有消融完全,避免针道出血、周围脏器损伤等特点,具有良好的临床应用价值。

The effect of laparoscopy combined with ultrasound-guided percutaneous radiofrequency ablation on hepatocellular carcinoma

Objective:To evaluate the clinical effect of combined application of laparoscopic surgery and ultrasound-guided percutaneous radiofrequency ablation for liver cancer.Methods:Combined application of laparoscopic surgery and ultrasound-guided percutaneous radiofrequency ablation were used to 56 patients of liver cancer. The postoperative data of vital sign,liver function,AFP and liver radiology after a month were collected. Results:Fifty-six patients with 108 lesions successfully underwent the combined laparoscopic surgery and ultrasound-guided percutaneous radiofrequency ablation,and no severe complications occurred,such as needle-path hemorrhage,liver failure or adjacent organs injury. 102 lesions (94.4%) were completely ablated,while 6 lesions were not. 2 patients with incomplete-ablation lesions were re-ablated in contrast-enhanced ultrasonography guidance and the other 4 patients were re-ablated in CT guidance. The effect of re-ablation was satisfying. Conclusions:With the advantages of complete ablation,and avoiding the bleeding caused by the needle and the injury of peripheral organs,combined application of laparoscopic surgery and ultrasound-guided percutaneous radiofrequency ablation shows its clinical feasibility as an effective treatment for liver cancer.