论文部分内容阅读
目的探讨特殊部位肝恶性肿瘤超声引导下经皮射频消融治疗的安全性、有效性及布针技巧。方法回顾分析2001年11月至2004年8月行超声引导下经皮冷循环射频治疗肝恶性肿瘤患者112例的资料,比较其中46例52个位于胆囊旁、包膜下、肝门部大血管旁等较特殊位置及66例86个非上述特殊部位肿瘤消融治疗的副作用及疗效。结果46例特殊部位肝肿瘤射频消融治疗均顺利进行,未发生严重的并发症,但局部肝周积液(17.4%)和胆囊壁水肿(19.6%)发生率高于非特殊部位组(P=0.0246,P=0.0009);术后1个月复查甲胎蛋白,甲胎蛋白的变化两组比较差异无显著性意义(P>0.05);术后3个月CT复查完全消融41个,局部残留10个,部分消融1个,与非特殊部位组比较差异无显著性意义(P>0.05)。结论靠近胆囊、肝包膜及肝门部等特殊部位的肿瘤并不是行冷循环射频治疗的禁忌证,只要进针点和路径选择合理,它仍然是一种有效的治疗方法。
Objective To investigate the safety and effectiveness of percutaneous radiofrequency catheter ablation guided by ultrasound in the treatment of hepatic malignancies in special sites and the techniques of cloth needle-guiding. Methods The data of 112 patients with malignant tumor of liver treated by ultrasound-guided percutaneous cold cycle radiofrequency were retrospectively analyzed from November 2001 to August 2004. Among them, 46 of 52 patients were located beside the gallbladder, under the capsule, Next to the more specific location and 66 cases of 86 non-specific parts of the tumor ablation treatment side effects and efficacy. Results Forty-six cases of liver tumor radiofrequency ablation were successfully performed without serious complications. However, the incidence of local peritumoral effusion (17.4%) and gallbladder wall edema (19.6%) was higher than that of non-special group (P = 0.0246, P = 0.0009). There was no significant difference between the two groups in the changes of alpha-fetoprotein and alpha-fetoprotein at 1 month after operation (P> 0.05). Complete CT ablation was performed at 3 months 10, partial ablation 1, compared with non-special part group no significant difference (P> 0.05). Conclusions Tumors close to the gallbladder, the hepatic capsule and the hepatic portal are not contraindicated in radiofrequency ablation of cold circulation. As long as the needle entry and path selection are reasonable, it is still an effective treatment.