经皮射频治疗肝脏恶性肿瘤114例临床分析

目的评价经皮射频(PRFA)治疗肝脏恶性肿瘤的效果、安全性和价值.方法应用RF-2000射频仪和10电极LeVeen射频针经皮穿刺治疗肝脏恶性肿瘤114例153个病灶,B超引导监测,局麻配合全身镇痛处理,对于肿瘤病灶＞2.5cm者进行分层多点叠合毁损,＞5.0cm或多发者配合肝动脉导管化疗栓塞术,随访观察治疗效果、并发症和生存情况.结果 PRFA成功率100%,并发症率6.14%(7/114),无相关死亡.3月、6月、1年、2年、3年生存率分别为100.00%(114/114),97.40%(111/114),74.60%(85/114),59.40%(41/69)和36.80%(7/19).结论 PRFA治疗肝脏恶性肿瘤具有微创、有效、简捷、实用、可重复、相对安全等优势,对各种类型不同大小的肝脏恶性肿瘤均有疗效.

Percutaneous radiofrequency ablation therapy for hepatic malignancies in 114 patients

Objective: To assess the local treatment efficacy and safety of percutaneous radiofrequency ablation (PRFA) therapy for hepatic malignancies. Methods: 153 malignant tumors of the liver in 114 patients were ablated by using RF-2000 generator and 10-needle LeVeen electrode percutaneously guided by B-ultrasound under sedation and local anesthesia. Lesions larger than 2.5 cm in diameter were treated by multiple overlapping ablations encompassing the entire lesion as well as a rim of normal liver tissue (approximately 1.0 cm), and the malignant tumors that were larger than 5.0 cm in size or multifocal were treated by in combination with transcatheter arterial chemoembolization (TACE). Results: The procedures were performed successfully in all cases. The post-PRFA complication rate was 6.14%, without PRFA-related death. The patients' survival rates were 100.00% (114/114) at 3 months, 97.40% (111/114) at 6 months, 74.60% (85/114) at 1 year, 59.40% (41/69) at 2 years, and 36.80% (7/19) at 3 years. Conclusions: It shows that with the advantages of being mini-invasive, simple and safe, PRFA is an effectie therapy in the comprehensive treatment of hepatic malignancies.