原发性肝癌超声引导下经皮射频消融治疗临床观察.docVIP

原发性肝癌超声引导下经皮射频消融治疗临床观察 　　[摘要] 目的 分析超声引导下经皮射频消融治疗原发性肝癌的临床疗效。 方法 对我科60例患者77个病灶经皮射频消融治疗的临床资料进行分析。 结果 51例患者术后超声造影检查病灶无增强，呈边界清晰的无回声区，提示肿瘤坏死。9例超声造影复查，考虑肿瘤残留。术前56例患者AFP增高，术后1个月有43例下降，余13例依然增高，术后2个月复查AFP时47例降至正常水平。术中8例出现疼痛，6例出现心率减慢，41例转氨酶升高，经积极治疗后恢复正常，未出现严重并发症。 结论 超声引导下经皮原发性肝癌射频消融是一种微创高效的治疗方法，值得临床推广。 　　[关键词] 超声介入；肝肿瘤；肝癌；射频消融 　　[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-9701（2015）26-0079-03 　　Clinical observation on the effect of radiofrequency ablation induced by ultrasound on primary liver cancer 　　ZOU Jianping1 XIE Xuping1 CAI Lianming1 XIAO Youhua1 SUN Bin2 　　1.Department of Abdominal Surgery， Ganzhou Tumor Hospital， Ganzhou 341000， China； 2.Department of Ultrasound，Ganzhou Tumor Hospital， Ganzhou 341000， China 　　[Abstract] Objective To investigate the effects of ultrasound-guided percutaneous radiofrequency ablation on hepatocellular cancinoma. Methods A total of 60 patients with 77 nodules of the primary hepatic carcinoma were treated with RFA at our hospital. Results In 51 cases， the lesions were not enhanced， and the tumor necrosis was suggested. 9 cases of ultrasound contrast examination， taking into account the residual tumor. AFP increased in 56 cases， 43 cases decreased after 1 months， the remaining 13 cases remained higher， 47 cases of were reduced to normal level after cases of AFP. During the operation 8 patients felt pain， 6 patients appeared slow heart rate， and 41 cases with elevated transaminase after the operation. No severe complication happened in this series. Conclusion Ultrasound-guided radiofrequency ablation is a micro-invasive， few complications safe and effective technique in the treatment of hepatic cancinoma.and was worth generalizing extensively. 　　[Key words] Ultrasound intervention； Hepatic tumor； Liver cancer； Radiofrequency ablation 　　原发性肝癌是消化系统最常见的恶性肿瘤之一，是来源于肝细胞或肝内胆管上皮细胞的恶性肿瘤，包括肝细胞肝癌、肝内胆管细胞癌和肝内细胞癌-肝内胆管细胞混合型等不同的病理类型。据我国最近的流行病学调查统计，肝癌死亡率占恶性肿瘤死亡率的第二位，并呈逐年增多的趋势。原发性肝癌的治疗方法包括手术切除、肝移植、局部消融治疗、肝动脉介入治疗等，每一种治疗方法都有其相应的适应证和禁忌证[1，2]。局部消融治疗具有微创、安全等优点