经皮经肝穿刺射频消融术治疗肝脏肿瘤

Percutaneous radiofrequency ablation for treatment of liver tumor

目的 探讨经皮经肝穿刺射频消融术 (PRFA)治疗肝脏肿瘤的适应证及疗效。方法 B超或CT引导下对 66例肝脏占位患者行 14 6例次PRFA ,治疗前后行AFP、B超或CT检查 ,6个月后随访。结果 所有患者均顺利实施PRFA ,2例治疗后出现严重并发症而死亡 ;6个月后随访肿瘤完全消失 6例 ,肿瘤直径缩小 1/2以上者 2 1例 ,肿瘤直径缩小 1/2以下者 2 4例 ,肿瘤直径无明显改变或增大 9例 ,死亡 4例。结论 PRFA具有简单、微创、安全、有效、多点反复治疗及对全身影响较小等优点 ,是肝脏肿瘤综合治疗的重要组成部分 ;对于直径较大的肿瘤 ,PRFA与TACE交替实施将会提高疗效 ;对肝功为ChildC级患者应慎重实施PRFA。

Objective To study the curative effect of percutaneous radiofrequency ablation (PRFA) on liver tumors. Methods A total of 66 patients underwent PRFA under ultrasound guidance for the total frequencies of 146. AFP, B-US, and CT examinations were conducted before and after the operation. A follow-up for 6 months was carried out. Results PRFA was successfully performed on all patients. Serious complications and death were found in 2 cases. The follow-up revealed complete disappearance of tumor masses in 6 cases. The diameter of tumor reduced by 1/2 were found in 24 cases, and <1/2 in 24 cases. No change of diameter of tumor or enlarged tumor mass was found in 9 cases and death in 4 case. Conclusion PRFA, simple, minimally invasive, safe, effective, and reproducible, is one part of the comprehensive therapy in liver tumors. Application of PRFA and TACE alternatively can improve the curative effect for tumors with large diameters. However, cautions should be taken into consideration when performing PRFA on patients with Child C tumors.