【摘要】 目的　探讨超声引导经皮射频消融 (PRFA)治疗肝癌的疗效及影响疗效的因素。方法　采用温控式多电极技术对 47例肝癌患者 6 7个结节行PRFA ,肿瘤直径 2 6± 1 1cm( 1 0～ 5 5cm)。　结果　肿瘤完全消融 (completedablation ,CA)率 :全组 80 6 % ,其中肿瘤≤ 3cm者 91 7% ,3 1～ 4 0cm者 75 0 % ,4cm以上者 14 3%。消融开始后 2min内达到 70℃的结节CA率显著高于 2min以上者 (P <0 0 5 ) ,治疗中维持温度达到 80℃以上者CA率也明显高于 70℃～ 80℃者 (P <0 0 1)。治疗后局部复发率 9 3% ( 5 / 5 4)。平均随访期间 11 3个月 ,远处复发 18例 ( 38 3% ) ,1年累计生存率82 1%。　结论　肿瘤大小、消融中局部组织的升温时间和维持的温度对PRFA的疗效有重要影响。更多还原

【Abstract】 Objective To investigate the therapeutic efficacy and its influencing factors of ultrasound-guided percutaneous radiofrequency ablation(PRFA) in the treatment of liver carcinoma. Methods With a temperature-controlled multi-electrode needle, ultrasound-guided PRFA was employed to treat forty-seven patients with 67 tumor nodules, with a diameter of 2.6±1.1 cm(1.0-5.5 cm). Results A complete ablation(CA) rate of 80.6% was achieved in the present series, with a CA rate of 91.7% in the tumors ≤3 cm in diameter, 75.0% in tumors from 3.1 to 4.0 cm, and 14.3% in tumors >4 cm. The CA rate was significantly greater in tumors with a temperature rising up to 70℃ within the initial 2 minutes at ablation as compared with that longer than 2 minutes(P<0.05). A markedly higher CA rate was obtained in tumors with an ablation-maintaining temperature of over 80℃ than that between 70℃ and 80℃ (P<0.01). All patients were followed up with a mean time of 11.3 months. The local recurrence rate was 9.3%(5/54), and 1-year survival rate was 82.1%. Eighteen patients (38.3%) had a distant recurrence. Conclusions The tumor size, temperature-rising time and ablation-maintaining temperature represented the important factors affecting the therapeutic efficacy of PRFA.更多还原