超声引导联合CT监视在特殊部位肝癌射频治疗中的应用价值

The Value of Radiofrequency Ablation in the Special Sites of the Liver Cancer by Combining Ultrasound Guided with CT Monitoring

目的探讨超声引导联合CT监视在特殊部位肝癌射频治疗中的应用价值。方法采用超声引导联合CT监视经皮射频治疗45例(75个病灶)特殊部位肝癌患者。统计消融术中、术后的并发症情况。1个月后复查CT、MRI资料,观察病灶的消融情况。结果消融术中无严重并发症,15例(33.3%)术后出现一过性发热;16例(35.6%)出现腹痛;3例顽固性咯呃逆;6例(13.3%)出现恶心。射频治疗后1个月随访显示,邻近膈肌13个病灶,其中病灶完全消融12个(92.31%);邻近胆囊8个病灶,完全消融6个(75%);邻近肠管5个病灶,完全消融5个(100%);邻近大血管9个病灶,其中病灶完全消融8个(88.89%),邻近胆管14个,其中病灶完全消融13个(92.86%)。45例患者仅1例靠近胆囊患者出现肝内肿瘤新生,无一例出现肝外转移。结论超声引导联合CT监视射频治疗特殊部位肝癌疗效满意,并发症发生率低,值得临床推广。

Objective To discuss the value of radiofrequency ablation in the special sites of the liver cancer by ultra- sound guided with CT monitoring. Methods 45 patients with a total of 75 special sites of malignant hepatic lesions were enrolled in this study. Intraoperative and postoperative complications were recorded. The therapeutic results were observed by analyzing the imaging data of the first month after Radiofrequency ablation Results No serious intraoperative or postop- erative complications were occurred, 15 patients （33.3%） had transient fever; 16 cases （35.6%）, had abdominal pain; 3 cases with intractable hiccups; 6 patients （13.3%） with nausea. Follow up were carried out one month after RF treat- ment. Of 13 lesions near the diaphragm, complete ablation was demonstrated in 12 （92.31%） ; 8 lesions adjacent gall- bladder, complete ablation in 6 lesions （75%） ; 5 lesions near adjacent bowel, complete ablation in 5 lesions（ 100% ） ; 9 lesions adjacent large blood vessels, complete ablation in 8 lesions （88.89%） ; 14 lesions adjacent bile duct, complete ab- lation in 13 lesions （92.86%）, only 1 case with the lesion near the gallbladder occurred tumorigenesis, no metastasis was found. Conclusion Clinical efficacy of radiofrequency ablation in the special sites of liver cancer by combining ultrasound guided with CT monitoring is satisfied with low complication and worthy of promotion.