论文部分内容阅读
目的:观察经皮射频毁损治疗肝脏肿瘤的近期疗效,探讨其最佳适应证和治疗相关因素。方法:应用RF2000型射频治疗仪、LeVeen多弹头射频电极,超声引导下经皮穿刺毁损,对60例肝脏肿瘤患者(87个肿瘤)进行了72次治疗,分别观察其毁损范围、AFP水平、肝功能反应、并发症等。结果:原发性肝癌肿瘤直径小于5cm者1次性完全毁损61.11%(11/18),3例2次治疗1例完全毁损;肿瘤直径5～10cm者31例2例1次性完全毁损(6.45%),其余均大部或部分毁损,2次治疗6例毁损范围扩大,均未完全毁损;直径大于10cm者11例1次治疗仅部分毁损,2次治疗2例仍有较大肿瘤组织残余。转移癌均为多发,肿瘤结节2～8个不等,1次治疗均未完全毁损,1例2次治疗效果不明显。术后复查,38例原发性肝癌(PHC)AFP升高者,15例AFP明显降低(39.47%),肿瘤直径小于5cm者AFP下降率为76.92%(10/13),5例完全阴转(38.46%)。所有患者均出现轻度的肝功能损害;并发自限性腹腔出血2例,胆漏、气胸各1例;3例肝硬化明显、且毁损范围较大者并发中、少量腹水,内科治疗均恢复。结论:经皮射频毁损治疗肝脏肿瘤是一安全有效的治疗方法,直径小于5cm的PHC或转移癌多可完全毁损,直径大于5cm者分次治疗,能明显减小肿瘤体积。
Objective: To observe the short-term therapeutic effects of percutaneous radiofrequency ablation on liver tumors, and to explore the best indications and treatment-related factors. METHODS: RF2000 radiofrequency therapeutic apparatus and LeVeen multi-warhead radiofrequency electrodes were used. Ultrasound-guided percutaneous puncture was used to treat 60 cases of liver tumors (87 tumors) for 72 treatments. The extent of lesions, AFP levels, and liver were observed. Functional reactions, complications, etc. Results: When the diameter of primary hepatocellular carcinoma was less than 5cm, 61.11% (11/18) of the lesions were completely destroyed. In 3 cases, 2 cases were completely destroyed; in 31 cases with tumor diameter of 5 to 10cm, 2 cases were completely destroyed (2 cases). 6.45%), most of the rest were partially or partly damaged, and the extent of damage was expanded in 6 cases of 2 treatments. None of them was completely destroyed; 11 cases of 1 case with diameter greater than 10cm were only partially damaged, and 2 cases of 2 cases still had larger tumor tissues. Residual. Metastatic cancers were multiple, tumor nodules ranged from 2 to 8, and none of the treatments were completely destroyed. The effect of 2 treatments in 1 case was not obvious. After the review, 38 cases of primary liver cancer (PHC) increased AFP, 15 cases of AFP decreased significantly (39.47%), tumor diameter less than 5cm AFP decreased rate was 76.92% (10/13), 5 cases completely negative rotation (38.46%). Mild liver function impairment occurred in all patients; 2 cases of self-limited intraperitoneal hemorrhage, 1 case of bile leakage and 1 pneumothorax; 3 cases of severe cirrhosis, and a large range of lesions with moderate or small amount of ascites, all recovered from medical treatment. . Conclusion: Percutaneous radiofrequency ablation is a safe and effective method for the treatment of liver tumors. PHC or metastatic carcinoma less than 5cm in diameter can be completely destroyed. Diameters larger than 5cm can be treated in divided doses, which can significantly reduce the tumor volume.