超声引导细刀头氩氦刀靶向冷冻治疗肝癌

Ultrasound-guided minimally invasive targeted Argon-Helium cryoablation in the treatment of hepatic carcinoma

目的探讨细刀头氩氦刀靶向冷冻毁损治疗肝癌的疗效。方法在超声引导下采用Cryo—Hit氩氦刀对27例肝癌经皮或开腹靶向冷冻治疗，其中原发性肝癌10例，复发性肝癌11例，转移性肝癌6例。结果27例冷冻治疗后无肝破裂、出血、胆漏等并发症发生。12例术前AFP值增高者（36．5—1200μg／L），术后AFP下降（8．0—254μg／L），其中6例恢复正常。3例术前CEA值升高，术后均下降，其中2例降至正常。术后随访1—3个月，59．2％（16／27）的病人CT或MR检查提示病灶完全坏死，25．9％（7／27）的病人CT或MR提示病灶有不同程度缩小，但仍见活动病灶。结论超声引导细刀头氩氦刀靶向冷冻治疗肝癌是安全、有效、操作简便，远期疗效还有待进一步观察。

Objective To explore the effectiveness of minimally invasive targeted Argun-Helium cryoablation in the treatment of hepatic carcinoma. Methods Ultrasound-guided Argun-Helium targeted cryoablation using the Cryo-Hit system was performed percutaneously or through laparotomy in 27 cases of hepatic neoplasms, including 10 cases of primary hepatic carcinoma, 11 cases of recurrent hepatic carcinoma, and 6 cases of metastatic carcinoma. Results No surgical death was found. There were no complications such as hepatic rupture, hemorrhage, or bile leakage. In 12 cases that had an increased AFP levels before the treatment （36.5 -1200 μg/L） , a decrease was observed （8.0 - 254 μg/L） and a recovery below the normal levels was noted in 6 cases. In 3 cases that had an increased CEA levels before the treatment, the levels reduced after the treatment and went down to the normal ranges in 2 cases. A follow-up survey was carried out for 1 - 3 months. CT scannings or MRI examinations found a complete tumor necrosis in 59.2% （16/27） of cases and a reduction of tumor size with various degrees in 25. 9% （7/27） of patients. Conclusions Ultrasound-guided targeted Argun-Helium cryoablation using the fine-probe Cryo-Hit system is a safe, effective, and simple procedure for the treatment of hepatic carcinoma, although its effectiveness still needs further verification.