超声引导下冷循环射频消融治疗肝脏肿瘤

目的　探讨超声引导下冷循环射频治疗肝脏肿瘤的疗效、适应证和并发症。方法　在超声引导局部麻醉下对 5 2例病人进行冷循环射频治疗肝脏肿瘤。肿块直径 1 0～ 13 6cm ,平均 3 6 7cm。结果　肿块直径 <3cm的完全消融 (CA)率为 88 4 % (38/4 3) ,3～ 5cm为 75 7% (2 8/37) ,>5cm为 33 3% (6 /18)。对其中 8个不完全消融肿块分别在术后 3～ 6个月再次行射频治疗。全组无术中死亡 ,无中转开腹手术 ,术后无病人出血。术中有 15 4 % (8/5 2 )出现腹痛 ,9 6 % (5 /5 2 )出现恶心 ,11 5 % (6 /5 2 )出现黄疸 ,32 7% (17/5 2 )出现一过性发热 ,1 9% (1/5 2 )出现胆漏。结论　超声引导下冷循环射频治疗对 <5cm肝脏肿瘤效果确切 ,并发症少。

Ultrasound-guided percutaneous radiofrequency ablation using "cool-tip needle" for treatment of liver tumors

Objective To investigate the efficacy, adaptation and complications of the "cool tip needle" radiofrequency ablation (RFA) for liver tumors. Methods Fifty two patients with hepatic malignancies underwent ultrasound guided RFA under local anesthesia. The tumors were 1 0 13 6 cm (mean = 3 67 cm) in diameter. Results The complete ablation (CA) rate of 88 4% (38/43) was seen in the tumors with a diameter less than 3 cm. The CA rate of 75 7% (28/37) was seen in tumors with a diameter of 3 5 cm it decreased to 33 3% (6/18) in tumors with a diameter over 5 cm. Eight patients showing no CA were treated with RFA 3 6 months later. No patient died and there was no change to celiotomy. No patient had hemorrhage after the treatment. The complications included abdominal pain in 8 patients (15 4%), nausea in 5 (9 6%), jaundice in 6 (11 5%), fever in 17 (32 7%) and biliary leakage in 1 (1 9%). Conclusions Ultrasound guided RF using "cool tip needle" is more effective in the patients with liver tumors of under 5 cm in diameter. Meanwhile, it is a safe way for treatment of liver tumors.