超声引导经皮消融术治疗复发性肝癌

目的　评价超声引导经皮消融术对复发性肝癌的治疗作用。方法　对复发性肝细胞癌14 1例6 2 8个结节分别采用了经皮超声引导下微波、射频、酒精和沸腾蒸馏水消融治疗,观察局部、远期疗效和对肝功能的影响。结果　肿瘤完全消融率92 . 0 % (5 78/ 6 2 8) ,微波、射频、酒精和沸腾蒸馏水的完全消融率分别为96 3% (10 5 / 10 9)、92 . 9% (119/ 12 8)、91. 5 % (311/ 340 )和84. 3% (43/ 5 1)。本组治疗后局部复发率13 5 % (78/ 5 78) ,微波、射频、酒精和沸腾蒸馏水的局部复发率分别为11 .4 % (12 /10 5 )、13. 4 % (16 / 119)、11.9% (37/ 311)和30 . 2 % (13/ 4 3)。14 1例患者经2～6 6月随访,117例患者(81% )的肝功能无明显变化。1、3、5年累计生存率分别为75 %、5 3%、2 6 %。结论　经皮消融治疗复发性肝癌对肝功能损伤小,能有效控制局部病变发展和改善患者的预后。

Ultrasound-guided percutaneous ablation of recurrent hepatocellular carcinoma

Objective To evaluate ultrasound-guided percutaneous ablation for recurrent hepatocellular carcinoma.Methods In this study, 141 patients with recurrent hepatocellular carcinoma (628 lesions) were treated by percutaneous ablation therapies, including microwave, radiofrequency, ethanol injection and hot distilled water ablation.Results The complete ablation rate was 92.0% (578/628) in this group, and was 96.3% ( 105/109 )? 92.9%(119/128)? 91.5% (311/340) and 84.3% (43/51), respectively, for microwave, radiofrequency, ethanol and hot distilled water ablation subgroups.The local recurrence rate was 13.5% ( 78/578 ), and was 11.4% (12/105)? 13.4% (16/119)? 11.9% (37/311) and 30.2% (13/43), respectively, for microwave, radiofrequency, ethanol and hot distilled water ablation subgroups.After a follow-up period of 2-66 months, liver function remained unchanged in 117 patients (81%) after ablation therapies.Patients were followed-up for 2-66 months, the 1, 3 and 5-year survival rate was 75%, 53% and 26%, respectively.Conclusion Ultrasound-guided percutaneous ablation therapies for recurrent hepatocellular carcinoma are safe and effective, while incuring minimal damage to liver function and improving long-term survival.