【摘要】 目的探讨规范化射频消融在特殊部位肝恶性肿瘤中的个体化治疗策略及疗效。方法回顾性分析2015年2月至2016年2月间收治的行射频消融治疗的57例肝恶性肿瘤患者临床资料。根据肿瘤发生部位分为常规组(肿瘤位于较安全区)37例,特殊部位组(肿瘤位于高危区)20例。常规组按照射频消融常规要求进行治疗;特殊部位组按照规范化射频消融治疗原则、个体化方案及流程进行治疗,均采用双电极射频消融治疗。射频消融治疗后1~2周复查超声造影及增强CT评价疗效。结果共射频消融治疗57例(病灶72个),肿瘤直径<3 cm 45个,3~7.1 cm 27个。两组患者射频消融治疗后影像学检查显示肿瘤一次性完全消融、残留后二次消融、联合粒子等治疗病例数分别为:常规组(35、2、0例),特殊部位组(15、2、3例);复查均稳定、无严重并发症。两组患者治疗后甲胎蛋白转为阴性或明显减低、癌胚抗原转为阴性或明显减低分别为:常规组(34、3例),特殊部位组(14、6例)。无严重并发症发生,均为一过性肝功能损害。两组间消融率及并发症比较差异无统计学意义(P>0.05)。结论规范化及个体化射频消融治疗特殊部位肝恶性肿瘤可取得预期效果,并避免多种严重并发症产生,值得推广与运用。更多还原

【Abstract】 Objective To explore the individual strategy and curative effect of canonical radiofrequency ablation(RFA) in intractable liver malignant tumor.Methods From February 2015 to February 2016,we retrospectively analyzed 57 patients with liver cancer(37General,20 Difficult),who treated with RFA.The general group treated in accordance with the requirements of conventional RFA.The difficult group in accordance with the principles of standardization of RFA of individual programs and processes for treatment,They were given double-electrode RFA,There were 48 cases of primary liver cancer,and 9 cases of liver metastases in the two groups.There were(44 men,and 13 female),with the aged from 45 to 85.Evaluation of curative effect was performed 1~2 weeks after RFA by contrastenhanced ultrasound and computed tomography.Results There were 57 cases(72 lesions) in the two groups,tumor diameter < 3 cm in 45 lesions,3~7.1 cm in 27 lesion.The General liver tumor are located in safe area,the Difficult tumor are located in high-risk areas,adjacent liver surface 10 lesions,3 lesions near gallbladder 2 lesions near cardiophrenic,3 lesions near intestine,11 lesions near vessels.The imaging examination after RFA of the two groups showed complete ablation of tumor disposable number,remaining after the second ablation therapy combined particles are as follows:General Group(35,2,0),Difficult group(15,2,3);review are stable,with no severe complication.Two groups of patients after treatment with AFP into negative or reduce obviously,CEA into negative or significantly reduced,respectively:General group(34,3),Difficult group(14,6).No serious complications were transient liver damage,local discomfort,fever.No serious complications occurred,only 1 difficult case appeared tumor peripheral bile duct injury,alleviated after PTCD.Ablation rate and complications between the two groups showed no significant difference(P < 0.05).Conclusion Standardized RFA of intractable liver tumor can achieve the desired effect,and avoid many serious complications,worthy of promotion and application.更多还原