射频消融术对肝脏肿瘤患者临床疗效及肝内感染的影响因素分析

Clinical efficacy of RFA for liver tumors and analysis of influencing factors of intrahepatic infections

目的探讨射频消融术对肝脏肿瘤患者的临床疗效以及肝内感染因素分析,以防止感染的发生。方法选取2013年1月-2014年12月肝脏肿瘤患者66例,在彩超引导下全麻进行射频消融治疗,调查患者术后一周内感染率,统计患者术后各类型肿瘤完全消融情况,随访两年记录患者肿瘤局部复发以及生存率。结果病灶直径<4cm患者肿瘤完全消融率显著高于病灶直径>4cm患者,病灶位置为非靠近大血管的肿瘤完全消融率显著高于病灶靠近大血管者,病灶直径<4cm者肿瘤局部复发率显著低于病灶直径>4cm以上者,病灶位置为非靠近大血管的肿瘤局部复发率显著低于病灶靠近大血管者,差异均有统计学意义(P<0.05);治疗后发生术后感染2例,以上因素可能与感染相关;患者一年生存率为95.5%、两年生存率为80.3%。结论射频消融术对肝脏肿瘤患者进行治疗,完全消融率高且两年局部复发率较低,患者术后感染例数较少,两年生存率较高,该治疗手段疗效显著,值得临床推广及应用。

OBJECTIVE To evaluate clinical efficacy of radiofrequency ablation for liver tumors and analyze iactors of intrahepatic infections to prevent infections. METHODS Totally 66 cases of liver tumors during Jan. 2013 to Feb. 2014 were selected and underwent ultrasound guided radiofrequency ablation under general anesthesia. Pa tients were observed for infection incidence in a week after the operation. Cases of complete ablation of various tumors were recorded and statistically summarized. Follow-ups of local tumor recurrence and patient survival rates in two years were recorded. RESULTS The complete ablation rate was significantly higher and the local tumor re- currence rate was significantly lower for patients with the lesion diameter 〈 4 cm than for those with lesion diame- ter 〉 4 cm, and for patients whose lesions were not close to large vessels than for those close to large vessels, the differences were significance （P 〈0.05）. Two cases had postoperative infections after treatment. The above two factors may be associated with infections. The one-year survival rate was 95.45 ~, and the two-year survival rate was 80.30%. CONCLUSION Radiofrequency ablation treatment of liver tumors has high complete ablation rate and low two-year local recurrence rate, the cases of postoperative infection are few, the survival rate is high in the two years, indicating that this treatment has a significant clinical efficacy, worthy of clinical promotion and applica- tions.