射频消融治疗肝癌115例报告

Radiofrequency ablation in the treatment of liver cancer:report of 115 cases

目的 总结2001年4月至2005年4月用射频消融（RFA）治疗肝癌病人的病例资料，探索RFA治疗肝癌的疗效及并发症防治。方法 经皮、经腹腔镜、开腹手术三种途径。采用B超、CT定位，多点穿刺行RFA治疗115例（原发性肝癌85例，转移性肝癌30例）肝癌患者。肿瘤直径1～8cm。其中3～5cm45例（39．1%），5～8cm42例（36．5％）；数目1～6个。结果 并发症发生率为11．3％，住院期间死亡2例。AFP阳性的60例肝癌病人中，RFA治疗后有46例（76．6％）明显降低，其中有35例（58．3％）转阴。1年生存率为78．2％，2年生存率为56．5％．〉3年生存率为36．5%。结论 采用不同径路、多点穿刺行RFA治疗无手术切除指征的肝癌、术后复发及转移性肝癌等临床治疗较困难的病例，疗效明显，并发症发生率低。

Objective To investigate the treatment efficacy of radiofrequency ablation （RFA） for hepatic malignancy and the relevant complications. Methods The clinical data of 115 patients with primary （n=85） or metastatic （n=30） liver cancer treated by RFA from April 2001 to April 2005 were analyzed retrospectively. The tumor diameter were 1t 8 cm and the tumour numbers 1 -6 . The operation were performed through percutaneous injection, under laparoscope or in routine open surgery. The multiple punctures guided by ultrasound or computerized tomography was used to treat liver cancer. Results The complication rate was 11.3%, and two patients died in the hospital. The AFP level of 46 patients （76. 6 %） decreased in total of 60 patients with positive AFP after RFA and AFP turned negative in 35 cases （58. 3%） , 78.2% of the patients survived for one year, 56.5% for 2 years and 36.5% for over 3 years. Conclusions The multiple puncture of RFA improves the curative effects greatly in the treatment of metastatic hepatic carcinoma, recurrent hepatic carcinoma after surgery and liver tumors which are unresectable , and the complications are few.