超声引导下经皮肝穿射频消融治疗肝癌的临床疗效观察

目的探讨超声引导下经皮肝穿射频消融治疗肝癌的临床疗效及安全性。方法回顾性分析108例原发或转移性、肿瘤直径<5 cm的肝癌患者,在超声引导下经皮肝穿单极或双极射频消融治疗的临床资料,检查术后不良反应及并发症发生情况。治疗后30 min其中62例患者69个结节行超声造影检查评估疗效,随访观察术前血清AFP升高者血清AFP水平变化、复发情况及1、2、3年生存率。结果 108例患者经射频消融治疗后并发症发生率:感染和发热66.7%(72/108),疼痛35.2%(38/108),肝功能一过性异常80.6%(87/108),胸腔积液3.7%(4/108);无手术死亡、腹腔出血、针道转移、邻近脏器损伤等严重并发症。69例术前血清AFP升高(632±58.35)μg/L]者术后1个月均下降(132±47.24)μg/L],其中41例降至正常水平。1、2、3年生存率分别为84.3%、61.1%、53.7%。结论射频消融治疗肝癌具有创伤小、对肝功能影响小、恢复快、操作简便,可补充或多次治疗,为不能手术切除的肝癌患者提供了一种更安全、有效的治疗方法。

Clinical curative effect of ultrasound guided percutaneous radiofrequency ablation on hepatocellular carcinoma

Objective To investigate the clinical efficacy and safety of percutaneous radiofrequency ablation guided by ultrasound in the treatment of liver cancer. Methods A retrospective analysis was done on 108 patients with primary or metastatic hepatocel- lular carcinoma （diameter 〈 5 cm ）. They underwent percutaneous transhepatic radiofrequency ablation （unipolar or bipolar） guided by ultrasound. Thirty minutes later, the efficacy was evaluated according to 69 nodules undergoing contrast-enhanced ultrasound in 62 patients. Results After treatment, infection and fever occurred in 66.7% （72/108） , pain in 35.2% （38/108） , transient abnormal liver function in 80.6% （87/108） , and pleural effusion in 3.7% （4/108） ; there were no operation death, abdominal bleeding, pin tract metastasis and adjacent viscera injury. The 69 patients with increased preoperative serum AFP level （ at 632 ± 58.35 μg/L） got a decrease in the level （ to 132 ± 47.24 μg/L） one month after operation, and in 41 of them the level decreased to normal level. The survival rates of 1-, 2- and 3-year were 84.3% , 61.1% and 53.7%. Conclusion Radiofrequency ablation in the treatment of liver cancer has less trauma and influence on liver function, and it is easy and fast to operate. It pro-vides a safe, effective treatment for the liver cancer patients unsuitable for an operation resection. s：