超声引导下经皮内冷循环射频消融肝癌的疗效观察

目的评价内冷循环射频消融肝癌的临床应用价值。方法 63例患者,97个肿瘤结节(直径2.2～7.0cm),应用Radionics公司生产的脉冲式冷循环射频仪,能量输入为120～200 W,持续时间12～15 min,在超声引导下应用18G针尖裸露长度为2～3 cm的内冷循环电极针进行RFA治疗。每个肿瘤结节治疗1次或3次,新发现的结节再次行RFA治疗。结果肿瘤完全坏死率在3个月、6个月、12个月分别为80.8%、75.6%、63.1%。存活率在3个月、6个月、1年、2年、3年分别为98.4%、93.6%、85.7%、61.9%、58.7%。34例原发性肝癌AFP升高患者中,23例术后1～3个月降为正常。10例转移性肝癌中CEA术前增高,术后明显下降,均未降到正常,维持在20 ng/ml左右,所有患者临床症状改善,2例发生并发症。结论超声引导下经皮内冷循环消融肝癌是有效和安全的方法。

Percutaneous Radio-frequency Ablation of Hepatic Cancer with Cooled-Tip Electrodes Guided by Ultrasound

Objective To evaluate the clinical value of radio-frequency(RF) ablation with cooled-tip electrodes in the treatment of hepatic cancer.Methods Sixty-three patients with ninety-seven hepatic cancer nodules(diameter 2-7 cm) were treated by using RF ablation with cooled-tip electrodes(18-gauge electrodes with 2-3 cm tip exposure) guided by ultrasound.Cold cycle and pulse radiofrequency instrument was applied,its energy input was 120-200 W,and the time lasted 12 to 15 minutes.Each nodule was treated in one or three treatment sessions;all the new nodules should be retreated with RF.Results The rate of complete necrosis of the entire tumor nodules was 80.8%,75.6% and 63.1% at 3,6 and 12 month,respectively.The overall survival rate was 98.4%,93.6%,85.7%,61.9% and 58.7% at 3 month,6 month,1 year,2 year and 3 year,respectively.Among 34 cases of primary liver cancer with elevated AFP,23 cases were dropped to normal in 1 to 3 months after surgery.The increased CEA in the preoperative in 10 cases of metastatic liver cancer were decreased significantly after surgery,but not to normal levels,and maintained at 20 ng/ml or so.The symptoms of all patients were improved.Two cases had additional complication.Conclusion The percutaneous radiofrequency ablation of hepatic cancer with cooled-tip electrodes guided by Ultrasound is effective and safe.