人工胸水辅助超声引导射频消融治疗肝脏膈顶部肿瘤

目的观察人工胸水辅助超声引导射频消融治疗肝脏膈顶部肿瘤的安全性及效果。方法选取肝脏膈顶部肿瘤患者11例（共15个病灶），向每例患者右侧胸膜腔内注入0．9％NaCl溶液500～1000ml，并在超声引导下对病灶进行射频消融治疗。结果所有患者人工胸水制作过程顺利，通过超声从肋间可清晰观察肿瘤，并可找到理想的穿刺路径。治疗后所有患者的胸水于1周内完全消失，CT或MRI增强扫描显示13个病灶（86．7％）完全坏死，2个病灶（13．3％）部分边缘区域仍有强化。所有患者未出现严重并发症。结论人工胸水辅助超声引导射频消融是治疗肝脏膈顶部肿瘤安全有效的手段。

Ultrasound-guided radiofrequency ablation with artificial pleural effusion for cancer of the liver located under the diaphragm

Objective To observe the safety and efficacy of ultrasound-guided radiofrequency ablation （RFA） with artificial pleural effusion for cancer of the liver located under the diaphragm. Method Fifteen lesions in 11 patients with cancer of the liver located under the diaphragm were treated by RFA with artificial pleural effusion, for which 500-1000 ml normal saline was injected into the pleural cavity. Results Artificial pleural effusion was finished successfully, the whole tumor for all of 15 lesions were visualized by ultrasound and the ideal puncture pathway were easy to find. The artificial pleural effusion was vanished within 1 week after operation. All of the lesions were treated with RFA and complete necrosis was obtained in 13 （86.7%） of the 15 lesions by CT or MRI. No severe complication was observed. Conclusion RFA with artificial pleural effusion is a safe and effective treatment option for patients with liver cancer under the diaphragm.