经皮射频治疗肝海绵状血管瘤的疗效与安全性分析

目的评价经皮射频(percutaneous radiofrequency ablation, PRFA)微创治疗肝脏海绵状血管瘤(hepatic cavernous hemangiomas,HCHs)的有效性和安全性. 方法应用RF-2000射频仪和10电极LeVeen射频针在超声引导下施行PRFA治疗HCHs 26例39个病灶直径2.5～11.0 cm,其中直径＞3.0 cm者予分层多点或多次叠合消融.局部麻醉,配合全身镇痛处理. 结果 26例均成功实施PRFA.反应期2～5天,包括局部疼痛不适、发热、ALT升高等,无胆漏、出血等并发症.23例随访1～5年,平均2年8个月,经一次治疗完全缓解(CR)22例,部分缓解(PR)1例,缓解率(CR PR)100%;HCHs直径平均缩小68.8%(41.2%～81.5%). 结论在掌握好适应证和操作技巧的前提下,PRFA可发挥微创、安全、有效之优势,可作为治疗HCHs的一种理想选择方法.

Evaluation of efficacy and safety of percutaneous radiofrequency ablation for hepatic cavernous hemangioma

Objective To study the efficacy and safety of minimally invasive therapy of percutaneous radiofrequency ablation (PRFA) in the treatment of hepatic cavernous hemangiomas (HCHs). Methods Ultrasound-guided PRFA was conducted in 26 patients with HCHs (39 lesions, 2.5~11.0 cm in diameter) by using the RF-2000 generator and the 10-needle LeVeen electrode. Lesions >3.0 cm in diameter were given multiple overlapping ablations that encompassed the entire lesions as well as an approximately 0.5 cm rim of normal liver tissue. The operation was performed under local anesthesia in association with systemic analgesia. Results The procedure was successfully accomplished in all the 26 patients. Adverse reactions happened at 2~5 postoperative days, including local pain and discomfort, pyrexia, and elevations of ALT levels. No bile leakage or hemorrhage occurred. Follow-up observations in 23 patients for 1~5 years (mean, 2 years and 8 months) showed a complete response (CR) in 22 patients and a partial response (PR) in 1 patient by one mission of PRFA, the effective rate (CR+PR) being 100%. The hepatic cavernous hemangiomas decreased by a mean of 68.8% (range, 41.2%~81.5%) in diameter. Conclusions Minimally invasive PRFA is a safe and effective therapy for HCHs in properly selected patients by experienced hands.