超声引导下射频消融治疗肝癌的临床价值

目的探讨超声引导下射频消融(RFA)治疗肝癌的疗效。方法35例肝癌49个病灶行超声引导下RFA治疗,对治疗前后病灶的超声影像、超声造影、螺旋CT检查、肝功能、AFP变化以及机体免疫功能的影响等进行综合研究以评价疗效。结果RFA后5min,超声造影,肿块中83.7%(41/49)各个时相无增强,即回声缺失;1周后彩超示肿块中87.8%(43/49)血流信号明显减少或消失;1个月后螺旋CT扫描肿块中81.6%(40/49)大小无明显变化,但肿块内无强化。肝功能有不同程度改善,甲胎蛋白下降,CD4 、CD4 /CD8 明显升高,sIL-2R明显降低。结论超声引导下射频消融治疗肝癌是有效的微创治疗手段,其为操作简便、损伤小、安全性高的有效方法。

Clinical Value of Ultransound-guided Radio-frequency Ablation on Hepatic Carcinoma

Objective To evaluate the clinical value of ultrasound-guided radio-frequency ablation(RFA) in treating liver cancer.Methods Thirty-five cases(49 tumors) with hepatocellular carcinoma were treated by ultrasound-guided radio frequency ablation(RFA).The changes of tumors after RFA were evaluated with color Doppler ultrasonography,contrast-enhanced ultrasonography,spiral CT,hepatic function examination,alpha fetoprotein(AFP) and the immune state.Results After five minutes of RFA,83.7% tumors (41/49) were not changed in contrast-enhanced ultrasonography at every phase;after one week,the blood stream signals of 87.8% tumors (43/49) were obviously reduced or disappeared on color Doppler ultrasonography;after one month,spiral CT showed that the size of lesions in 81.6% tumors (4o/49) had no variability,but the tumors exhibited attenuation at the arterial phase and the portal venous plase and the hepatic function was improved;the AFP was decreased,CD4 and CD4 /CDS values were increased and sIL-2R were markedly decreased.Conclusions Radio-frequency ablation under ultrasonic guidance is a simple,safe,effective and micro-invasive method in the treatment of hepatocellular carcinoma.