肝癌的氩氦刀冷冻治疗近期疗效的探讨

Investigation of the short term curative effect of argon-helium cryosurgical treatment in liver carcinomas

目的探讨氩氦刀冷冻治疗肝癌的方法、安全性及近期疗效。方法CT引导下经皮穿刺氩氦刀冷冻治疗68例肝癌患者,术中经2次循环冻-融,1周后行肝动脉造影、TACE或灌注化疗,术后行增强CT或DSA随访。结果肿瘤最大径≤5cm的肝癌14例,术中完全消融。肿瘤最大径5～10cm的肝癌54例,其中29例术前未给予TACE,术中均未完全消融;25例术前行1～3次TACE,20例(80%)完全消融。全组病例术中无死亡,术后无出血、胆瘘、肝破裂及穿刺道转移等并发症。术后平均随访12.5个月,CR1例,PR36例,SD21例,PD10例,1年生存率为98.5%(67/68例)。结论CT引导下肝癌的经皮穿刺氩氦刀冷冻治疗是一种安全、有效、微创的治疗方法。

Objective To evaluate the short term curative effect, ways and safety of argon-helium eryosurgieal treatment for liver carcinomas. Methods Percutaneous endoeare cryocare system for sixty-eight cases of liver carcinoma were undertaken Argon-Helium cryosurgical treatment guided by CT with two freezethaw recycles. Hepatic arteriographies were done 1 week afterward with TACE or perfusion chemotherapy and then with enhanced CT or DSA follow up. Results 14 cases of tumor maximum diameters ≤ 5 cm were completely ablated by the operation. 54 cases of diameters ≥ 5 - 10 cm of whom 29 cases treated with out preoperative TACE were not completely ablated and 25 cases treated with preoperative TACE for one to three times were 80% （20/25 cases）completely ablated. All cases showed no mortality, no haemorrhage, hepatorrhexis, no biliary fistula and no metastasis of punctural path post-operatiively. Average follow-up was 12.5 months including CR in 1 case, PR in 36cases, SD in 11 cases, PD in 9 cases and 1 year survival rate of 98.5%（67/68 cases）. Conclusions Cryoablation offers a safe, minimaltrauma and effective way in the treatment of liver cancer through percutaneous approach of endocare cryocare system under CT guidance.