氩氦刀冷冻消融治疗肝癌

目的观察氩氦刀治疗5 cm以内原发肝癌或肝转移瘤的疗效。方法收集5 cm以内原发肝癌或肝转移瘤患者31例,共39个病灶。所有患者均于CT或超声等影像引导下接受氩氦刀治疗。结果肿瘤消融范围为90%100%,完全消融病灶占69.23%（27/39）。1年和2年存活率分别为90.32%（28/31）、61.29%（19/31）。31例患者均无出血等严重并发症,术中寒战4例（12.90%）;肝区疼痛6例（19.36%）,重度疼痛1例,体表皮肤温度触冰感,CT扫描无出血迹象,生命体征稳定,给予强痛定止痛,效果差,术后2 h疼痛缓解,其余疼痛患者均为中、轻度疼痛,未予处置;术后发热7例（22.58%）,体温37.1238.25℃;无血管、胆管损伤病例;冷冻术后患者的精神状态得到改善,腹部疼痛症状减轻,恢复较快。结论对于不能手术切除的小肝癌和肝转移瘤,氩氦刀消融治疗安全性高、疗效可靠。

Percutaneous argon-helium cryoablation for hepatic malignancies

Objective To observe the efficacy of percutaneous hepatic cryoablation for the treatment of primary or meta-static hepatic malignancies (<5 cm in diameter).Methods A total of 31 patients (39 tumors <5 cm in diameter) were treated with argon-helium cryoablation system under the guidance of CT or ultrasound.Results Tumor ablation range was 90%-100% in 39 lesions,including 69.23% (27/39) complete ablation.The 1- and 2-year survival rate was 90.32% (28/31) and 61.29% (19/31),respectively.No bleeding and injury of blood vessel or bile duct was noted.Complications of cryoablation included intraoperative shivering in 4 (12.90%) patients,postoperative fever (37.12-38.25℃ in 7 (22.58%) patients and hepatic pain in 6 (19.36%) patients.One patient had severe pain relief until 2 h after cryosurgery with ice-cold skin temperature and stable life index,analgesic had little effect,and no bleeding was found on CT image.Other patients had slight or moderate pain and remained untreated.Conclusion Percutaneous targeted argon-helium cryoablation is a feasible and safe technique in the treatment of small primary or metastatic hepatic malignancies not suitable for resection.