【摘要】 目的 研究射频消融(RFA)对肝脏恶性肿瘤的治疗效果。方法 对30例肝脏恶性肿瘤患者共38个病灶CT引导下进行经皮射频消融治疗,大小2.5～12 cm,其中原发性肝癌26例,转移性肝癌4例。应用美国RIDA 1500型射频消融仪,电极针为15G的9根伞状排列的可伸缩针,电极针打开后最大直径可达5 cm。术前术后均进行增强CT扫描,并定期随访。结果 RFA操作均顺利完成。平均5.5 d后患者康复出院或接受其他方案治疗。治疗结束后即刻CT平扫,肿瘤内有小点状气体形成者20例,30 d后螺旋CT扫描,增强后38个结节中,直径≤3 cm的4个病灶全部坏死,直径在3～5 cm之间12个病灶,7个全部坏死,5个部分坏死,直径>5 cm的22个病灶5个全部坏死,均为先行1～2次经肝动脉导管化疗栓塞治疗病人,17个病灶部分坏死。术后常见并发症主要为肝区疼痛、发热、气胸及胸腔积液,无射频治疗相关的死亡。结论 CT引导下经皮射频消融是一种安全有效治疗肝脏恶性肿瘤的方法。更多还原

【Abstract】 Objective To investigate the efficacy and safety of radiofrequency ablation(RFA) in treating malignant liver tumors.Methods Thirty patients with total 30 malignant liver tumors including 26 hepatocellular carcinomas(HCC) and 4 metastatic tumors were percutaneously treated with radiofrequency ablation on CT-guided by using RITA RF-1500 generator and StarBurst XL electrosurgical device.Preoperative and postprocedural contrast-enhanced CT scans were taken in all 30 patients.The therapeutic efficacy was evaluated by enhanced CT one month after the RFA.Results The procedures were performed successfully in all patients and the patients recovered or received orther treatment 5.5 day later.There was no treatment-related mortality in the studied group.Among the 38 tumors,4 tumors with lesion diameter of 3 cm or less and 7 of 12 tumors with lesion diameter of 3～5 cm treated by radiofrequency ablation alone showed complete tumor ablation,5 of 22 tumors with lesion diameter larger than 5 cm treated with a combination of radiofrequency ablation and chemoembolization showed complete tumor ablation on the 1-month follow-up enhanced CT.The major complications included transient fever and right upper quadrant pain,small amount of pnemothrax and reactive pleural effusion.Conclusion Radiofrequency ablation is effective and reliable in treating malignant liver tumors.更多还原