肝癌深度冷冻治疗围手术期并发症13例分析

An analysis for postocryosurgery complications in patients with liver tumors

目的 探讨肝癌深度冷冻治疗围手术期并发症。方法 应用LCS 2 0 0 0型深度冷冻治癌机治疗肝癌患者 6 5例 ,男性 6 0例 ,女性 5例 ,年龄 2 6～ 72岁 ,中位年龄 5 4 8岁 ,癌灶直径小于 5cm16例 ,5～ 10cm 2 4例 ,大于 10cm 2 5例。其中原发性肝癌 5 4例 ,国际TNM分期Ⅱ期 12例 ,Ⅲ期 14例 ,Ⅳa期 2 2例 ,Ⅳb期 6例。乙肝表面抗原 (HBsAg)阳性率 94% (5 1/ 5 4) ,甲胎球蛋白 (AFP)阳性率 70 %(38/ 5 4)。继发性肝癌 11例 ,原发癌为结肠癌 4例、直肠癌 2例、胆囊癌 2例、胰腺癌 1例、乳腺癌 1例、后腹膜平滑肌肉瘤 1例。结果 全组围手术期并发症 13例 16个 ,并发症发生率 2 0 % (13/ 6 5 )。包括术后腹内出血 3例、肝功能衰竭 3例、上消化道出血 6例、感染 4例。结论 肝癌深度冷冻治疗为部分不能手术切除的患者提供了有效的治疗手段 。

Objective To study the postocryosurgery complications in patients with liver tumors.Methods Cryogenic surgical LCS 2000 system was used for the tratment of 65 patients with primary and secondary liver cancers.There were 60 males and 5 females.The tumor was less than 5 cm in diameter in 16 cases,5～10?cm in 24 cases and larger than 10?cm in 25 cases.There were 54 patients with primary liver cancer,among them 12 cases on tumor TNM classification Ⅱ,14 on Ⅲ, 22 on Ⅳa and 6 on Ⅳb.There were 11 patients with secondary liver cancer,the primary foci were found in gastrointestinal tract,breast and retroperitonium, respective.[]ResultsSixteen postotherapy complications developed in 13 patients.With an incidence of 20%(13/65),and the mortality of 3 1%(2/65).Complications that developed were as follows:intra abdominal bleeding in 3 cases,hepatic failure in 3 cases,upper digestive tract bleeding in 6 cases,infection in 4 casesConclusion Liver cryosurgery is a relatively new form of treatment for unresectable liver cancer that involves in situ ablation of liver tumor by freezing with liquid nitrogen.A surgeon must adhere strictly to the indication of operation.