论文部分内容阅读
目的探讨经皮冷循环射频消融治疗T1a期肾细胞癌的安全性和疗效。方法初诊为T1a期单发肾细胞癌的患者15例,肿瘤位于左肾6例、右肾9例。术前常规行肾脏增强CT检查明确肿瘤的大小和位置,肿瘤直径1.1~3.9cm,平均直径为(2.7±1.1)cm。所有患者均行经皮冷循环射频消融治疗。术后定期随访,比较手术前与手术后第1天、第1周、第1个月、第3个月时,患者的血红蛋白和血清肌酐水平、红细胞沉降率、患侧肾小球滤过率,并行肾脏增强CT检查观察病灶情况。结果 15例患者均成功接受经皮冷循环射频消融治疗,无1例发生严重手术并发症,均于术后第2天出院。与术前比较,术后各时间的血红蛋白和血清肌酐水平、红细胞沉降率、患侧肾小球滤过率的差异均无统计学意义(P值均>0.05)。术后第1周,肾脏增强CT检查见原肿瘤区域呈低密度影;术后第1个月,肾脏增强CT检查见病灶完全消融13例、消融不全2例,完全消融率为13/15;术后第3个月,肾脏增强CT检查见病灶完全坏死14例、部分坏死1例,完全消融率为14/15。术后随访2~22个月,中位随访时间为9.3个月,15例患者均生存,无1例发生局部或远处复发。结论经皮冷循环射频消融治疗T1a期肾细胞癌是安全、有效的。
Objective To investigate the safety and efficacy of percutaneous cold cycle radiofrequency ablation in the treatment of T1a renal cell carcinoma. Methods The newly diagnosed T1a single renal cell carcinoma in 15 patients, the tumor located in the left kidney in 6 cases, 9 cases of right kidney. Preoperative routine renal enhanced CT examination of the tumor size and location clear, tumor diameter 1.1 ~ 3.9cm, the average diameter of (2.7 ± 1.1) cm. All patients underwent percutaneous cold cycle radiofrequency ablation. The patients were followed up regularly. The levels of hemoglobin, serum creatinine, erythrocyte sedimentation rate, ipsilateral glomerular filtration rate (GFR) in patients before and after surgery were compared between the first day, the first week, the first month, the third month, , Parallel renal enhanced CT examination to observe the lesion. Results All the 15 patients were successfully treated with radiofrequency ablation by percutaneous cold cycle. None of the patients had serious surgical complications. All patients were discharged on the second postoperative day. Compared with the preoperative, hemoglobin, serum creatinine, erythrocyte sedimentation rate and ipsilateral glomerular filtration rate were not significantly different at any time after operation (P> 0.05). In the first week after operation, renal CT examination showed low density of the original tumor. In the first month after operation, 13 cases were completely ablated, 2 cases were completely ablated, and the complete ablation rate was 13/15. In the third month after operation, kidney enhanced CT showed complete necrosis of the lesion in 14 cases, partial necrosis in 1 case and complete ablation rate of 14/15. The patients were followed up for 2 to 22 months. The median follow-up time was 9.3 months. All 15 patients survived without any local or distant recurrence. Conclusion Percutaneous cold cycle radiofrequency ablation of T1a renal cell carcinoma is safe and effective.