冷循环射频消融微创治疗肝癌的临床研究

CLINICAL RESEARCH ON RADIO FREQUENCY ABLATION THERAPY WITH MICRO INVASION FOR LIVER CANCER

目的 :探讨运用超声引导冷循环射频消融治疗肝癌的微创技术并评价其治疗效果及临床应用价值。方法 :应用美国RF2 0 0 0型射频治疗仪 ,集束针或单针射频针。经彩色多谱勒超声定位引导后在局部麻醉下将射频电极针由定位点经皮肝穿刺进入瘤体对肿瘤进行毁损。根据肿瘤体积大小 ,分点对瘤体进行分次射频热毁损治疗。对瘤体直径小于 5cm者多用单针 ,大于 5cm者主要用集束针治疗。应用此方法共对我院 2 0 0 1年 11月～ 2 0 0 3年 2月间的 14 1例肝脏肿瘤患者进行了治疗。结果 :14 1例病人治疗后部分出现腹水、一过性黄疸、发热、顽固性右侧胸腔积液并发症 ,部分患者疼痛缓解。原发性肝癌肿瘤直径小于 5cm者 4 3例 ,仅部分完全性毁损。肿瘤直径大于 5cm者 79例行多点多次治疗 ,3次治疗后仍有肿瘤组织残余。治疗前共有 10 5例患者AFP≥ 4 0 0 μg/L。术后复查 ,部分患者的AFP出现不同程度的下降 ,以直径小于 5cm的原发性肝癌患者下降明显。治疗后B超均表现整个病灶回声增强或部分病灶回声增强 ,病灶内检测出血流信号减少或消失。CT示治疗区强化减弱 ,肿瘤缩小或液化坏死表现。结论 :冷循环射频消融微创治疗肝癌作为肿瘤热治疗的一种方法 ,是一种微创、时间短、安全方便、疗效可靠的新方法。

Objective:To explore the micro invasive technique to treat the liver cancer by using radio frequency ablation under the guidance of color Doppler ultrasonography and evaluate its clinical effects and values.Methods:Use the RF2000 style cool radio frequency ablation treatment system. Insert the needle percutaneously to destroy the tumors guided by ultrasonography after local anesthesia. Destroy the tumor according its volume. Use the single needle to treat the small hepatic cancer and multi needles to tumor over 5 cm. 141 patients were treated by this way from Nov, 2001 to Feb, 2003.Results:Some of the patients were suffered from ascites, temporary jaundice, fever, and right obstinate pleural effusion separately after treatment. Only some of the 43 primary hepatocarcinoma cases whose diameters were below 5cm were fully destroyed. 79 patients whose tumors diameters were over 5cm accepted multi-point treatment with several times.The Tumors were partly alive after 3 times treatment. There were 105 patients whose AFP≥400μg/L before treatment. The post-operation test showed that the tumor signs which were below 5cm declined obviously. The echo of the full focus or part focus increased. The blood signals were detected to decrease or disappeared. CT showed that contrast of the therapeutic area was weakened. The tumor manifested diminution or liquefaction and necrosis.Conclusion:RFA is a kind of new way for hepatocarcinoma treatment. It is micro invasive, safe, convenient and effective.