射频消融治疗肝脏肿瘤的临床研究

Clinical reasearch on radiofrequency ablation therapy for liver cancer

目的 探讨运用冷循环射频消融技术治疗肝脏肿瘤的效果及其临床应用价值。方法 应用美国RF2000型冷循环射频治疗仪，在局部麻醉或静脉麻醉下将电极针经皮穿刺入瘤体内损毁肿瘤组织，或在开腹直视下行肝穿刺进入瘤体损毁肿瘤组织。对于肿瘤直径较大（〉8cm）或是肿瘤数量较多（〉3个）的患者采用射频治疗和超声聚焦刀、肝动脉栓塞化疗联合的方式进行治疗。用上述方法对2001年11月～2006年6月的347例肝脏肿瘤患者进行了治疗。结果 347例病人中肿瘤单发直径小于或等于3cm者24例，肿瘤完全性毁损。肿瘤单发直径大于3cm小于8cm者89例部分肿瘤完全性损毁。肿瘤多发或单发直径大于8cm者234例，经多点多次联合治疗后仍有肿瘤残余。治疗前甲胎蛋白（alpha，fetop rotcin，AFP）大于或等于400μg／L者261例。术后复查，大部分患者AFP出现不同程度下降。治疗后CT显示治疗区域肿瘤缩小液化坏死或强化减弱。结论 冷循环射频消融是一种创伤小、容易耐受、时间短、安全方便的治疗肝脏肿瘤确实有效的方法。

Objective To explore the clinical effects and value of radiofrequency ablation in treating liver cancer. Methods Use the RF2000 style cool radiofreqeuncy ablation treatment system. Insert the neddle percutaneously to destroy the tumor after local or vein anesthesia or insert the neddle directly during operation. A total of 347 patients were treated this way from Nov. 2001 to Jun, 2006. Results Only 24 patients with single tumor whose diameters were below 3 cm were fully destoryed. Eighty-seven patients with single tumor whose diameters between 3 cm to 8 cm were partly destroyed. Those who have more than one tumor and whose diameters were over 8 cm accepted multi-point treatment with several times and combination treatments, but the tumors were still partly alive. There were 261 patients whose AFP 〉 ≥400 μg/L before traetment, the post-operation test showed that AFP in some of them declined obviously . CT showed that the tumor manifested diminution or liquefaction and the contrast of the therapeutic areas were weakened. Conclusion Radiofrequency ablation is an effective way for hepatocarcinoma treatment. It is invasive, safe, well torlernt, and convenient.