肝动脉化疗栓塞后冷循环射频消融联合高温蒸馏水瘤内注射治疗肝癌的价值

The value of cold circulative radiofrequency ablation combined with percutaneous hyperthermal distilled water injection therapy in the treatment of liver neoplasms after transcatheter arterial chemoembolization

目的:观察肝动脉化疗栓塞(TACE)联合超声引导下冷循环射频消融(RFA)、高温蒸馏水瘤内注射(PHDT)治疗肝癌的临床疗效。方法:对112例经临床、病理、血清肿瘤标记物与典型影像学诊断证实的肝癌行综合介入治疗,其中原发性肝癌81例,转移性肝癌31例。先行TACE治疗,术后2～4周行RFA治疗,间隔3～7天再对残余癌灶行PHDT治疗,一周后重复注射至残癌被完全浸润。治疗后通过强化CT、DSA及血清肿瘤标记物测定评价疗效。结果:112例共167个病灶行综合介入治疗,随访6～36个月,肿瘤缓解率95.2%,6个月、1年、3年生存率分别为100%、87.5%、46.4%。结论:TACE联合RFA、PHDT治疗肝癌具有明显的协同互补作用,能显著改善患者的生活质量,提高生存率。

Objective：To observe clinical curative effect of transcatheter arterial ehemoembolization （TACE） combined with cold circulative ra- diofrequency ablation （RFA） and percutaneous hyperthermal distilled water injection therapy （PHDT） in the treatment of liver neoplasms. 112 patients with clinical and pathological, serum tumor marker and typical imaging diagnostic proof of liver neoplasms received comprehensive intervcntional treatment, of which 81 cases of primary liver cancer,31 cases of metastatic liver neoplasms, first TACE treatment, 2～4 weeks after, RFA treatment, Interval 3 ~ 7 days, PHDT treatment of residual loci, a week later repeated injections Until the residual tumor was fully infiltrates. After treatment through enhanced CT, DSA and the determination of serum tumor markers evaluated. Results： Follow - up 6 ~ 36 mouths, tumor response rate was 95.2% （ 159/167 ） ,6 months, 1 year,3 years survival rates were 100% ,87.5% ,46.4%. Conclusion： TACE combined wih RFA, PHDT treating liver neoplasms has obvious synergy complementary role,can markedly improve the pafient~ quality of life,improve survival.