【摘要】 目的探讨术中多极射频消融(RFA)在肝脏恶性肿瘤(特别是消化道恶性肿瘤肝脏转移肿瘤)中的作用、适应症及其安全性。方法 2011年8月至2012年3月,我科共收治应用术中RFA的肝脏恶性肿瘤患者20例。术前影像学发现20例患者的肝脏共有37个病灶;对于直径≤5 cm的病灶采用"一针穿刺,多极消融"的空间布针方案,对于直径>5 cm的病灶采用"多针穿刺,盐水增强消融"的空间布针射频方案。结果所有患者均顺利完成手术及RFA治疗,所有患者术后7天复查肝脏增强CT,所有消融病灶均显示为低密度液暗区,19例患者肝脏组织毁损范围超过术前病灶体积。其中直径≤5 cm的肝脏单个射频消融病灶患者13例术后随访2~7个月,肝脏未发现复发病灶。术中针道出血2例,予以缝合止血,余病例未发生腹腔内出血、胆道损伤、针道种植转移、肝功能衰竭等射频消融并发症。结论射频消融是一种微创治疗,手术联合RFA治疗肝脏恶性肿瘤近期疗效确切,安全性好,适应症广。其远期疗效、与肝脏恶性肿瘤其他治疗方案疗效的比较尚待进一步观察。更多还原

【Abstract】 Objection To investigate the effection、indication and safety of the introoperative ablation(RFA) in the cure of hepatic maglignant tumor.Method During 2011 August to 2012 March,our department treated a total of 20 patients with hepatic maglignant tumor,include primary liver cancer in 7 cases,and metastatic liver cancer in 13 cases.preoperative imaging find a total of 37 hepatic lesions in 20 cases.the diameter ≤5 cm lesions using"a needle,multipolar ablation"space needle arrangement scheme;and the diameter > 5cm lesions using"multi-needle,multipolar ablation"space needle arrangement scheme.Results The operation and RFA treatment were successful in all patients.Patients reviewed hepatic CT after 7days after operation.ablation lesions showed low density area,and the liver tissue damage range exceeded preoperative lesion volume in 19 patients.13 cases who just have a single hepatic lesion with the diameter ≤5 cm were followed up 2 ~ 7 months and no recurrence.There are intraoperative needle tract bleeding in 2 cases,and they were suture hemostasis,the other patients have no intraoperative complications.Conclusion Intraoperative RFA in treatment of hepatic malignant tumors have curative effect,good safety and wide indication.when the patient can not tolerate larger extent of liver resection with severe liver cirrhosis or have multiple hepatic metastases,they can be effectively treated,control the hepatic injury.But the long term efficacy and curative effective comparison of RFA should be further observed更多还原