冷循环射频消融联合门静脉穿刺栓塞治疗肝癌的临床应用

目的　研究冷循环射频消融联合门静脉穿刺栓塞治疗肝癌的方法和疗效。方法　 2 0 0 1年 7月至 2 0 0 2年 2月 ,30例肝癌病人接受冷循环射频消融联合门静脉穿刺碘油栓塞治疗 ,术后观察病人主要临床症状 ,AFP浓度 ,肝功能变化 ,B超和CT观察肿瘤大小及瘤体中心血流变化情况 ,碘油沉积情况。结果　 10例肿瘤射频治疗区周边有碘油沉积 (强回声区 ) ,局部穿刺活检证实有残留癌细胞。 2 5例病人术前感肝区疼痛 ,治疗后 2 1例病人疼痛消失。 2 6例血清AFP大于正常值 ,治疗后 1个月复查降至正常 16例。B超和CT检查 :2 6例病人肿瘤缩小 ,平均缩小 (2 5± 0 4 5 )cm ,10例病人肿瘤部分或完全液化。无手术死亡病例。结论　冷循环射频消融联合门静脉穿刺碘油栓塞是一种安全、有效并互相协同的肝癌治疗方法。

Cool-tip radio-frequency ablation in combination with portal vein embolism in treatment of hepatocarcinoma

Objective To evaluate the method and effects of cool-tip radio-frequency ablation (RFA) in combination with portal vein embolism (PVE) in treatment of hepatocarcinoma. Methods From July 2001 to February 2002, 30 patients with hepatocarcinoma were treated with percutaneous and ultrasound-guided cool-tip RFA in combination with PVE in our hospital. After treatment, the main symptoms, AFP level and liver function were observed. Meanwhile, ultrasonography, CT scanning and biopsy were performed. Results Lipidol deposition in the edge of tumors treated cool-tip RFA in combination with PVE where remaining cancer cells were confirmed by biopsy was found in 10 patients. The abdominal pain vanished in 21 patients. In 26 patients with abnormal AFP level, the AFP level dropped to normal in 16 within 1 month after the treatment. The lesions significantly decreased in size in 26 patients and partially or completely liquified in other 10. Conclusion Cool-tip RFA in combination with PVE is a safe, effective and congenerous treatment for primary hepatocarcinoma.