冷循环射频消融治疗88例结直肠癌肝转移临床疗效

Clinical Therapeutic Analysis of Cold-Circulation Radiofrequency Ablation in the Treatment of 88 Colorectal Cancer Patients with Liver Metastasis

目的探讨冷循环射频消融治疗结直肠癌肝转移的疗效、适应证及并发症。方法回顾性分析2012年7月至2015年10月,昆明医科大学第一附属医院干疗科收治的88例行冷循环射频消融治疗的结直肠癌肝转移患者临床资料,其中5例患者行开腹直视冷循环射频消融治疗,其他83例患者行B超引导下经皮穿刺冷循环射频消融治疗。结果所有患者肝转移病灶总数为125个,总消融病灶119个,6个病灶由于位置特殊、定位困难、射频消融风险较大等原因未予射频消融。术后1月复查超声造影,109个病灶完全消融毁损,10个病灶怀疑有肿瘤残留,均给予再次消融。患者随访1、2、3a生存率分别为100%、93.1%、76%,无射频消融相关死亡。结论结直肠癌肝转移患者通过冷循环射频消融治疗,获得了较好的疗效,将射频消融技术灵活运用于结直肠癌肝转移患者,具有较高的临床应用价值。

Objective To investigate the clinical efficacy,indications and complications of cold-circulation radiofrequency ablation in the treatment of liver metastases from colorectal cancer patients.Methods Clinical data of 88 colorectal cancer patients with livermetastasis,which were selected from July 2012 to October 2015 in our department and treated by radiofrequency ablation,were analyzed retrospectively.Among them,five patients were treated with open abdominal radiofrequency ablation,meanwhile the other 83 patients were treated with percutaneous cold circulation radiofrequency ablation guided by B-ultrasound.Results The total number of liver metastases in all patients was 125,and 119 lesions were completely destroyed by radiofrequency ablation.Moreover,six lesions were not destroyed by radiofrequency ablation due to their special location,difficult positioning,or high risk of operation.One month after operation,all patients were examinedby contrast-enhanced ultrasonography.The results showed that 109 lesions were completely ablated and destroyed,10 lesions were suspected of tumor residue,All of them were treated with re-ablation ablation,the survival rate was 100%,93.1%and 76%in the 1,2 and 3 years respectively.No radiofrequency ablation related deaths occurred.Conclusion Cold-circulation radiofrequency ablation technique has achieved good results in patients with liver metastases from colorectal cancer.The flexible application of radiofrequency ablation inpatients with liver metastasis from colorectal cancer has high clinical application value.