“主供血管先行”的双针联合射频消融治疗肝脏巨大血管瘤的效果观察

目的探讨“主供血管先行”的双针联合射频消融(RFA)治疗肝脏巨大血管瘤的临床疗效。方法28例肝脏巨大血管瘤患者在超声引导下行RFA治疗,观察患者术中、术后的反应及并发症,术后复查血常规、肝肾功能,并行上腹部增强CT或增强MRI检查,了解病灶消融情况,进行疗效评价。结果28例患者均顺利完成RFA治疗,平均治疗时间为61.9 min。其中,21例患者在RFA术后出现一过性发热;25例患者术后出现血清ALT、AST水平升高;一过性肉眼可见血红蛋白尿19例;无出血、胆漏、肾功能不全等并发症发生。所有患者术后均获得随访,随访时间12~36个月,平均18个月,期间无远期并发症发生。28例患者中,病灶完全消失有22例(79%),病灶缩小>50%共6例(21%),疾病缓解率为100%。结论对于肝脏巨大血管瘤,“主供血管先行”的双针联合射频消融疗效确切,且具有微创、安全、简便、可靠的优点。

Objective To investigate the clinical efficacy of"main donor vessels first"combined with radiofrequency ablation(RFA)in the treatment of hepatic giant hemangioma.Methods Twenty-eight patients with large hemangioma of the liver were treated with RFA under ultrasound guidance,and the intraoperative and postoperative reactions and complications were observed.Postoperative blood routine examination,liver and kidney functions were reviewed,and upper abdominal enhanced CT or MRI was performed to understand the lesion ablation status and evaluate the efficacy.Results All 28 patients successfully completed RFA therapy,and the average treatment time was 61.9 min.Among them,21 patients developed transient fever after RFA.Senim ALT and AST levels were increased in 25 patients after operation.Transient visible hemoglobinuria was observed in 19 cases.No bleeding,biliary leakage,renal insufficiency and other complications occurred.All patients were followed up for 12 to 36 months,with an average of 18 months,during which no long-term complications occurred.In 28 patients,22 cases(79%)of the lesions disappeared completely,and 6 cases(21%)of the lesions shrank>50%.The disease response rate was 100%.Conclusion For large hemangioma of the liver,the"main donor vessels first"two-needle combined radiofrequency ablation is effective,and has the advantages of minimally invasive,safe,simple and reliable.