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目的探索开腹射频治疗在不可切除肝癌的治疗效果。方法2006年5月至2008年11月引进Cool-tip冷循环超能射频治疗仪对不可切除肝癌(原发和转移)26例46个病灶在B超引导下施行了开腹射频消融(RFA)治疗,同期,经皮不可切除肝癌射频治疗17例。结果所有病人得到随访,术后定期行AFP、B超和(或)CT检查,最长随访时间28个月,最短1个月,平均12.8个月。术前AFP增高10例,术后3个月内全部恢复正常;1例CT发现可疑针道残留,3例随访过程出现肝脏新的转移灶;1例RFA治疗后9d死于持续腹腔出血,1例肝切除+RFA治疗后30d死于腹腔出血和感染,2例于随访过程中死于多发转移(分别生存7个月、4个月)。结论开腹B超引导的射频消融治疗与肝癌切除手术有机结合可以拓展肝癌外科治疗的范围,有利于提高肝癌的整体疗效。
Objective To explore the therapeutic effect of open radiofrequency ablation in unresectable liver cancer. Methods From May 2006 to November 2008, 26 patients with unresectable hepatocellular carcinoma (primary and metastatic) including 46 lesions underwent B-mode ultrasonography with Cool-tip ultrashort radiofrequency ablation (RFA) 17 cases of radiofrequency treatment of percutaneous unresectable liver cancer. Results All patients were followed up. AFP, B ultrasound and / or CT were performed regularly. The longest follow-up time was 28 months and the shortest one month, with an average of 12.8 months. Preoperative AFP increased in 10 cases, all within 3 months after surgery to return to normal; 1 case of suspected suspicious needle pathological CT, 3 cases of liver metastasis occurred during follow-up; 1 case of RFA died 9d after continuous intra-abdominal hemorrhage, 1 Cases of hepatic resection + RFA died of intraperitoneal hemorrhage and infection 30 days after treatment, and 2 died of multiple metastases during follow-up (7 and 4 months, respectively). Conclusion The combination of radiofrequency ablation guided by open ultrasound and liver resection can expand the scope of surgical treatment of liver cancer and improve the overall curative effect of liver cancer.