射频消融治疗肝肿瘤315例报告

Radiofrequency ablation in the treatment of liver tumor: report of 315 cases

目的总结1999年6月至2003年8月用射频消融(radiofrequency ablation,RFA)治疗315例肝肿瘤病人的病例资料,探索RFA治疗肝肿瘤近远期疗效.方法采用了一次定位、多点穿刺,RFA联合肝动脉栓塞(TAE)、选择性门静脉栓塞(SPVE)治疗直径5～13 cm的大肝癌,及经皮经肺经膈肌RFA治疗膈顶部肝癌.结果总并发症发生率为5.1%,无一例住院期间死亡.AFP阳性的169例肝癌病人中,RFA后有124例(73.6%)明显降低,其中有95例(56.2%)转阴.半年生存率为89.5%,1年生存率为80.1%,18个月生存率为61.4%,24个月生存率为48.3%,>36个月生存率为35.6%.结论采用TAE、SPVE及RFA一次定位多点穿刺法治疗无手术切除指征的中晚期(含大肝癌)的病人,疗效明显,总并发症发生率低.

Objective To explore the short-term and long-term curative effects of radiofrequency ablation （RFA） in the treatment of liver tumor. Methods The clinical data of 315 patients treated by RFA from June 1999 to August 2003 were analyzed retrospectively. The methods of one localization and multiple puncture, RFA combined with TAE and SPVE were used to treat large liver cancer. Liver tumors located on the top of the diaphragm were treated by percutaneous, trans-pulmonary and trans-diaphragmatic RFA. Results Complications occured in 5. 1% of the cases and no one died in the hospital. AFP level was lowered in 124 out of 169 patients with positive AFP （73.6%） after RFA. AFP was negative in 95 cases （56.2%）. 89.5% of the patients survived half a year. 1-year, 18-month and 36-month survival rate was 80. 1%, 61.4%, and 48. 37%, respectively. 35.6% of the patients survived over 36 months. Conclusions The methods of one localization and multiple puncture RFA combined with TAE and SPVE improved the curative effects in the treatment of large liver tumor greatly, and the complications are less.