摘要
目的 :探讨射频消融 (radio frequencyablation ,RFA)联合经门静脉化疗栓塞术治疗原发性肝癌的可行性及其临床疗效。方法 :选取经肝动脉化疗栓塞术 (transcatheterarterialchemoembolizalion ,TACE)治疗效果不理想的原发性肝癌患者 2 8例共 4 9个癌灶 ,行经皮超声引导下的RFA ,随后穿刺供瘤门静脉分支 ,对肿瘤行化疗栓塞术 (碘油 +丝裂霉素C) ,治疗后 1个月、3个月以临床表现、AFP、B超、CT指标综合评价治疗效果。结果 :2 8例中成功施行RFA +经门静脉化疗栓塞术 2 6例共 4 6个病灶。治疗后 1个月、3个月发生肝区疼痛、腹胀、乏力、纳差、消瘦、黄疸等症状的患者例数明显减少 ,同术前比较有显著性差异 (P <0 .0 5 ) ;治疗前、治疗后 1个月、3个月的平均肝功能Child评分分别为 (9.8± 2 .4 )分、(9.3± 2 .1 )分和 (8.1± 1 .9)分 ,治疗后 1个月和治疗前的评分差异无统计学意义 (P >0 .0 5 ) ,而治疗后 3个月评分则显著低于治疗前 (P <0 .0 5 ) ;治疗后 1个月、3个月AFP >4 0 0 μg/L的患者比例及AFP测值均显著低于治疗前 (P <0 .0 5 ) ;综合B超和CT结果示治疗后 1个月 86 .4 %的肿瘤病灶被彻底毁损 ,复发或未被彻底毁损继续行上述治疗 ,3个月时肿瘤病灶的完全毁损率达 94 .9%。所有患者在治疗中和治疗后?
Objective:To inquire into the feasibility and clinical effect of the combination treatment for primary liver carcinoma with radio frequency ablation(RFA) and trans portal vein chemoembolization(TPCE).Methods:28 cases of primary liver carcinoma with 49 neoplasms, who had acquired poor therapeutic efficacies from the treatment of transcatheter arterial chemoembolizalion(TACE),were collected and treated with the combination of RFA and TPCE(iodized oil+mitomycin-C). 1 and 3 months after the treatments,the clinical manifestations,AFP,B ultrasound and CT results were harvested to assess the therapeutic efficacies.Results:Of the 28 cases,26 cases with 46 neoplasms were successfully administered with the combination of RFA and TPCE. The cases with pain in hepatic region,abdominal distention,inertia,anorexia,emaciation and jaundice decreased significantly in 1st and 3rd month after the treatment when compared with those of pre treatment(P<0.05);the Child scores of liver function of pre treatment,1,3 month of post treatment were (9.8±2.4),(9.3±2.1) and (8.1±1.9),respectively. There was no significant difference in the score between pre treatment and 1 month of post treatment(P>0.05),but the score of 3 month of post treatment was significantly lower than that of pre treatment(P<0.05);the ratios of the cases of AFP>400 μg/L and the determined values of AFP were significantly lower in 1st and 3rd month after the treatment than those of pre treatment(P<0.05);in the comprehensive analysis of B ultrusound and CT results,86.4% of the neoplasms were thoroughly ablated at 1 month after the treatment. The relapsing and un thoroughly ablated neoplasms were continuously treated with combination of RFA and TPCE. The thoroughly ablating rate was 94.4% till 3 month after the treatment. No severe complications related to the treatment developed during and after the treatment.Conclusion:The combination treatment of RFA and TPCE is simply operated,safe,effective for the primary liver carcinoma,and it can be an alternative treatment for the patients who got poor therapeutic efficacies from the TACE.
出处
《肝胆胰外科杂志》
CAS
2004年第2期106-109,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
肝肿瘤
原发性
射频消融
经门静脉
介入治疗
primary liver neoplasms
radio-frequency ablation(RFA)
trans-portal vein
interventional therapy
