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目的探讨80岁以上原发性肝癌患者行热消融治疗的治疗效果。方法选取2010年12月至2016年9月间中国医学科学院肿瘤医院收治的31例原发性肝癌患者的临床资料,所有患者均为接受经皮射频消融或经皮微波消融治疗的80岁以上原发性肝癌患者,收集患者的并发症及生存预后资料,分析热消融治疗的治疗效果。结果高龄原发性肝癌患者手术操作时间为40~145分钟,中位手术操作时间为80分钟。术中发生并发症者3例,其中严重心律失常2例、高血压危象1例,积极处理后均好转。发生严重术后并发症者5例,其中门静脉血栓1例,右侧胸腔积液2例,严重腹水2例。患者住院时间为4~10天,平均5.4天。肿瘤消融治疗后30天内无一例患者死亡。高龄原发性肝癌患者完全消融率为95.3%,生存时间3~72个月,中位生存时间26个月,术后1年和2年的生存率分别为74.2%和51.6%。结论对80岁以上高龄肝癌患者经皮热消融安全有效,适于临床推广。
Objective To investigate the therapeutic effect of thermal ablation in patients with primary liver cancer over 80 years of age. Methods The clinical data of 31 patients with primary liver cancer who were admitted to Tumor Hospital of Chinese Academy of Medical Sciences from December 2010 to September 2016 were selected. All patients were over 80 years old receiving percutaneous radiofrequency ablation or percutaneous microwave ablation Patients with hepatocellular carcinoma, comparisons of patients with complications and prognosis of survival data, analysis of the therapeutic effect of thermal ablation. The results of elderly patients with primary liver cancer surgery time was 40 to 145 minutes, the median operation time was 80 minutes. Intraoperative complications occurred in 3 cases, of which 2 cases of serious arrhythmia, hypertension crisis in 1 case, were positive after treatment were improved. Serious postoperative complications in 5 cases, including portal vein thrombosis in 1 case, right pleural effusion in 2 cases, severe ascites in 2 cases. Patients hospitalized for 4 to 10 days, an average of 5.4 days. None of the patients died within 30 days after tumor ablation. The complete primary liver cancer patients with complete ablation rate of 95.3%, survival time of 3 to 72 months, the median survival time of 26 months, 1 year and 2 year survival rates were 74.2% and 51.6%. Conclusion The percutaneous thermal ablation of liver cancer patients over 80 years old is safe and effective, suitable for clinical promotion.