摘要
目的 :评价射频毁损 (RFA)治疗原发性肝癌 (HCC)的近期疗效、安全性及并发症。方法 :采用RF - 2 0 0 0型射频治疗仪 ,在B超引导下经皮RFA治疗 96例HCC患者。结果 :96例HCC患者 (肝功能Child分级 :A级72例 ,B级 18例 ,C级 6例 )共 14 7个肿块 (平均直径 6 .6 0± 3.13cm ,1.9～ 15cm ,完成 12 0次治疗 ,平均治疗1.3次。CT证实 14例瘤体未彻底毁损 (平均直径 9.5 1± 2 .82cm ,5 .0～ 15cm) ,2例失访 ,80例瘤体完全毁损(平均直径 6 .0 9± 2 .0 2cm ,1.9～ 13.7cm) ,其中 78例平均随访 9.2月 (1～ 16月 ) ,4 3例复发 (5 5 .1% ) ,其中 2 3例肿瘤原位复发 (2 9.5 % )。 35例未见复发 (44 .9% )。多因素相关分析 ,原位复发与肿块直径呈显著正相关(P =0 .0 0 0 1)。 10例 (10 .4 % )发生并发症 ,无射频治疗相关的死亡。最常见的不良反应为吸收热 ;患者术后肝功能轻度损害 ,2周左右恢复至基线水平。结论 :经皮RFA是一种治疗HCC较安全有效的非手术方法 ,肿瘤直径是影响RFA疗效的主要因素。
Objective:To evaluate the safety, efficacy and complication of radiofrequency ablation (RFA) in treatment of hepatocellular cancer(HCC).Methods:96 HCC patients (72 of Child class A, 18 of Child class B, 6 of Child class C) with 147 tumors (with the median diameter of 6.60±3.13cm, 1.9～15cm) were treated by electrodes inserted to the foci percutaneously under ultrasound guidance using RF2000 generator for 120 times in total (on average for 1.3 times per patient). Results:In 14 patients the ablated tumors (median diameter of 9.51 +2.82cm, range 5.0 to 15cm) were considered to be incompleted ablation by early post-RFA spiral CT; 2 patients were lost without being examed by post-RFA CT; In 80 patients the treated tumors (median diameter of 6.09±2.02cm, range 1.9 to 13.7cm) were completely necrotic, of these 80 patients, 78 patients were followed up for 9.2 months on average (1 to 16 months) to assess the recurrence of ablated tumors. Local tumor recurrence at the RFA site developed in 23 patients(29.5%) and 35 patients remained clinically free of tumor. Multivariate analysis demonstrated that the tumor diameter were related significantly to local recurrence ( P =0.0001). 10 patients(10.4%) had complications,No treatment-related death took place. The common response after RFA was mild fever. The serum ALT and TBIL were transiently elevated one day after RFA in al 1 patients, and returned to baseline values in 2 weeks. Conclusion:RFA is a safe and effective nonoperative treatment for HCC; Tumor diameter is the most important factor related to RFA efficacy.
出处
《中国现代医学杂志》
CAS
CSCD
2003年第4期39-42,共4页
China Journal of Modern Medicine
