规范化射频消融治疗肝脏肿瘤

Ultrasound-guided percutaneous radiofrequency ablation of hepatic malignancies with cool-tip needle

目的探讨规范化射频消融治疗肝脏肿瘤的疗效、适应证、并发症和治疗规范。方法严格按照术前评估、术中完全损毁和术后即时评价的规范化操作程序，对421例肝脏肿瘤患者进行冷循环射频消融治疗，共634处病灶，行射频消融1121次。结果全组421例患者无术中死亡。全部634处病灶中有514处完全消融，占81．1％。其中最大径〈3cm病灶的完全消融率为91．4％（382／418），3-5cm病灶为78．9％（97／123），〉5cm病灶为37．6％（35／93）。术后有147例（34．9％）出现一过性发热，136例（32．3％）出现腹痛，38例（9．0％）出现恶心，12例（2．9％）出现胸腔积液，2例（0．5％）出现肝脓肿，1例（0．2％）出现胆漏。结论规范化射频消融治疗肝脏肿瘤效果确切，无严重并发症发生。

Objective To investigate the efficacy, indication and complication of radiofrequency ablation （RFA） with cool-tip needle in patients with hepatic malignancies. Methods 421 patients with hepatic malignancies underwent ultrasound-gnided RFA with cool-tip needle under local anaesthesia. The tumor size was fi＇om 1.0 to 15 cm in diameter with an average diameter of 4.3 cm. Results The complete ablation （CA） rate was 91.4% （382/418） in the patients with a tumor 〈 3 cm, 78.9% （97/123） in those with a tumor of 3 to 5 cm and 37.6% （35/93） in the patients with a tumor 〉 5 cm. No patient died or changed to cellotomy during the 1121 times of RFA for 634 lesions in 421 patients. No hemorrhage oceurreded in any of these patients after the RFA treatment. The complications included abdominal pain in 32.3% （ 136/421 ）, nausea in 9.0% （38/421）, fever in 34.9% （ 147/421 ） and biliary leakage in 0.2% （ 1/421 ） of the patients. Conclusion Ultrasound-guided percutaneous radiofrequency ablation with cool-tip needle is effective and safe in the treatment of liver tumors.