肝癌射频消融联合无水酒精注射治疗后急性肾功能衰竭的防治

Prevention and Treatment for Acute Renal Failure Following radiofrequency Ablation Combined with Ethanol Injection for Liver Cancer

目的：探讨肝癌射频消融联合无水酒精注射治疗后并发急性肾功能衰竭的防治措施。方法：回顾性分析我院2002年8月至2005年5月射频消融联合无水酒精注射治疗29例肝癌中2例并发急性肾功能衰竭的临床资料。结果：有2例患者分别于术后第21天及第25天出现急性肾功能衰竭，经治疗后1例死亡，1例好转。结论：射频消融联合无水酒精注射治疗肝癌，一次性消融的组织太多有可能会并发致命性急性肾功能衰竭。其发生原因的可能与原有慢性肾损害、肝功能损害、肝肿瘤较大治疗后广泛坏死、坏死物质吸收、继发感染、血压降至太低有关。

Objectives： To investigate the prevention and treatment of acute renal failure following radiofreuquency ablation combined with ethanol injection（RFA ＋ EI） for liver cancer. Methods： The clinical date of 29 cases with liver cancer who under went radiofrequency ablation combined with ethanol injection（ RFA ＋ EI） consecutively between Aug 2002 to May 2005 in our hospital were analyzed retrospectively. Results： Actue renal failure developed in 2 cases among 29 after 21 day and 25 day following radiofrequency ablation combined with ethanol injection respectively. One case died and the another recovered after treatment. Conclusion： It may be complicated with fatality acute renal failure following radiofrequency ablation combined with ethanol injection for liver cancer. The etiology of acute renal failure following RFA ＋ EI is multifactorial, with chronic renal failure liver function damaged. The size of the zone of coagulative necrosis, absorbed the necrosis substance, secondary infection and the low renal perfusion.