射频消融治疗肝血管瘤的疗效及预后分析

Evaluation of efficacy and prognosis of radiofrequency ablation for the treatment of hepatic hemangiomas

目的:评价射频消融(Radiofrequency ablation,RFA)治疗肝脏血管瘤(Hepatic hemangiomas)的有效性和预后。方法:应用绵阳立德LDSF-120S射频仪和7电极射频针在超声引导下施行RFA治疗肝血管瘤16例20个病灶直径3.0～10.0cm,其中直径>3.5cm者予以分层多点或多次叠合消融。局部麻醉,配合全身镇痛处理。结果:16例均成功实施RFA。反应期2～5d,包括局部疼痛不适、发热、ALT升高等,无胆漏、出血等并发症。16例随访1～3年,平均1年8个月,经1次治疗完全缓解(CR)15例,部分缓解(PR)l例,缓解率(CR+PR)100%;血管瘤直径平均缩小62.0%(50.1%～84.7%)。结论:在掌握好适应证和操作技巧的前提下,RFA可发挥微创、安全、有效之优势,可作为治疗肝血管瘤的一种理想选择方法。

Objective：To study the efficacy and prognosis of radio-frequency ablation （RFA） for the treatment of hepatic hemangiomas. Methods：Ulthrasound-guided RFA was conducted in 16 patients with hemangiomas（20 lesions,3.0～10.0 cm in diameter）bv using the Li-De generator and the 7- needle electrode. Lesions 3.5cm in diameter were given multiple overlapping ablations that encompassed the entire les- ions.The operation was performed under local anesthesia in association with systemic analgesia. Results：The procedure was successfully accomplished in all the 16 patients. Adverse reactions happened at 2 ～5 postoperative days,including local pain and discomfort,pyrexia,and elevations of ALT levels. No bile leakage or hemorrhage occured.Follow-up observations in 16 patients for 1～3 years （mean,1 years and 8 months）showed a complete response （CR）in 15 patients and a partial response （PR）in l patient by one mission of RFA,the effective rate （CR＋PR）being 100%.The hepatic hemangiomas decreased by a mean of 62.0%（range,50.1%～84.7%）in diameter. Conclusion：RFA is a safe and effective therapy for liver hemangiomas in properly selected patients by experienced hands.