超声引导经皮穿刺冷冻治疗肝癌的实验和临床研究

EXPERIMENTAL AND CLINICAL STUDY ON ULTRASOUND-GUIDED PERCUTANEOUS CRYOSURGERY FOR PRIMARY LIVER CANCER

目的 探讨经皮穿刺冷冻治疗原发性肝癌的应用价值.方法①家猪12只,腹腔镜下显露肝脏,Trocar针穿刺腹壁,经一非金属鞘将冷冻头插入肝右叶冷冻;②11例原发性肝癌,超声引导穿刺扩张皮肤直至肝内肿瘤表面,保留一非金属鞘,LCS-2000冷冻机5mm冷冻头经鞘管插至肿瘤中心冷冻.结果①实验动物术后无腹腔内出血,冷冻穿刺部位无严重冻伤;②11例病人冷冻后恢复均顺利,其中5例肿瘤缩小≥50%,1例肿瘤完全消失.结论 超声引导下经皮冷冻治疗肝癌是一种安全可行、新型微创的局部治疗新方法.

Objective:Ultrasound-guided percutaneous cryosurgery was performed to evaluate this technique as one kind of treatment option for primary liver cancer (PLC). Methods : ①Twelve pigs underwent abdominocentesis with trocar, a 5mm cryoprobe was inserted into liver via a nonmetal cannula for cryosurge. ②11 patients with PLC were treated by inserted percutaneously a 5mm cryoprobe into the tumor under ultrasound monitoring for cryosurgery. Results :①All animals no have intraperitoneal hamorrage after cryosurgery, and no seriours cold injury at the site of paracentesis. ②The postoperative course was uneventful in all 11 patients. After cryosurgery, 5 patients'tumor reduce ≥50%,and in one of them,no tumor was identified by CT scan. Conclusion:Ultrasound-guided percutaneous cryosurgery is a safe, effective and microtrauma new approach for primary liver cancer.