氩氦靶向冷冻术在中晚期肝癌综合治疗中的应用

目的 探讨氩氦靶向冷冻综合治疗中晚期肝癌的疗效。方法 应用美国恩多凯尔公司生产的氩氦超导手术系统(Endocare Cryocare System,氩氦刀)对80例中晚期肝癌分别采用B超或CT引导经皮穿刺氩氦靶向冷冻切除术，术中直视下B超引导氩氦刀冷冻加手术切除术，氩氦刀联合肝动脉介入栓塞化疗术(TACE)，氩氦刀联合瘤内无水酒精注射术。结果 全组无手术死亡及严重并发症，冷冻术后CT影像学上改变CT值明显降低，肿块逐渐缩小，65．0％病人AFP值显著下降，临床症状改善，损伤小、并发症少、恢复快。结论 氩氦靶向冷冻综合治疗肝癌疗效明确，对正常肝组织损伤少，并可产生肿瘤免疫抗体，能弥补单用TACE及瘤内注射无水酒精治疗的不足，具有安全、有效、微创，为目前中晚期肝癌治疗提供一种有效的疗法。

APPLICATION OF CRYOTHERAPY COMBINATION WITH SYSTEMIC THERAPY FOR PATIENTS WITH ADVANCED HEPATIC CARCINOMA

Objective To discuss the results and safety of cryotherapy for advanced hepatic carcinoma combination with systemic therapy. Methods 80 patients with advanced hepatic carcinoma were enrolled. Cryotherapy under B ultrasound or CT guidance, open cryosurgery using intraoperative ultrasound plus resection, combination with transcatheter hepatic arterial chemoembolization(TACE), percutaneous ethanol injection(PEI) were performed.Results No operation related death or severe complication was observed. The CT value decreased markedly after cryotherapy and the tumor size diminished gradually. The blood levels of AFP decreased significantly in 65.0% of patients. The clinical symptoms were improved. Operative complications were slight. All the patients recovered rapidly. Conclusion Cryotherapy is an effective and safe method for advanced hepatic carcinoma, and can make up the deficiency of TACE and PEI.