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目的探讨多发性肝癌同期行肝切除和术中超声引导下射频消融的治疗价值。方法回顾性分析2005年1月-2013年4月收治的33例多发性肝癌患者资料,均同期行手术切除肝叶或肝癌,术中在超声引导下行其余多发性肝癌射频消融术。共有肿瘤灶91个,其中手术切除39个,射频消融52个。术后1、2、3年行超声造影和增强CT/MRI复查。结果所有患者术中均无大出血,无患者死亡。术后肝功能一过性损害,经保肝治疗后均恢复到A级。无围手术期死亡等严重并发症。术后1、2、3年肿瘤复发率分别为16.1%、48.4%、93.5%。结论肝切除同期术中超声引导下射频消融治疗多发性肝癌安全可行,不增加患者住院时间、手术病死率及术后肿瘤复发率。
Objective To investigate the value of concurrent hepatectomy and intraoperative ultrasound-guided radiofrequency catheter ablation in patients with multiple liver cancer. Methods The data of 33 patients with multiple liver cancer admitted from January 2005 to April 2013 were retrospectively analyzed. Surgical resection of hepatic lobe or liver cancer was performed in the same period. The patients underwent ultrasound-guided radiofrequency ablation of the remaining multiple hepatic cancers. A total of 91 tumor nests, of which 39 were surgical resection, radiofrequency ablation 52. Postoperative 1, 2, 3 years underwent ultrasound contrast and enhanced CT / MRI review. Results All patients had no major bleeding during operation and no patient died. After a transient damage to liver function, liver protection after treatment were restored to A level. No serious complications such as perioperative deaths. The recurrence rates at 1, 2 and 3 years after operation were 16.1%, 48.4% and 93.5% respectively. Conclusions In the same period of liver resection, ultrasound-guided radiofrequency ablation is a safe and feasible method for treating multiple hepatic cancers without increasing hospital stay, operative mortality and postoperative tumor recurrence rate.