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肝癌射频原位灭活治疗的研究 |
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吴金生 褚延魁 马庆久 刘灏
【摘 要】 目的 研究射频技术肝癌原位灭活治疗的方法及疗效。方法 在B超引导下将中空金属钛多极穿刺针经皮直接穿刺置入瘤体，分点1次或多次对瘤体进行 射频热毁损治疗。射频输出功率由20W每隔一分钟增加20W，直至90W，治疗时间设定为15分 钟，术后观察病人的AFP、B超(瘤体大小、回声、血流)、CT图像及病理变化。结果 180例病人中AFP高于正常者(153例)射频治疗1周后复查119/153(77.8%)下降为正常； 2～4周和部份治疗不完善者经过第2次治疗后144/153(94.1%)下降为正常；B超和CT图像上 表现为肿瘤无增大、缩小或液化，瘤体多普勒观察瘤体内无血流信号；术后病理学复查示治 疗区为坏死组织伴血管栓塞，142例病人术前伴疼痛，治疗后121/142(85.2%)疼痛消失，其 余疼痛缓解。术后26/180(14.4%)的病人出现腹水、一过性黄疸16/180(8.9%)。结论 射频原位灭活是创伤小、疗效快、安全、有效的肝癌治疗方法。
【关键词】 肝癌 射频 治疗
Radio frequency ablation to treat hepatocellular carcinoma
Wu Jinsheng，C hu Yankui，Ma Qingjiu，et al.
(Department of Surgery，The Tangdu Hospital of Forth Military Medical University，Xi'an 710038)
【Abstract】 Objective To evaluate the results and feasible methods of s onographically-guided Radio-Frequency ablation for the treatment of primary or secondary hepatocellular carcinoma.Methods 180 patients with h epatocellular carcinoma were t reated with percutaneous，ultrasound-guided RF ablation.RF was applied with freq uency at 20W to 90W for 15 minutes，over multi-treatment session.After RF treatm ent，the AFP level changes were observed.The ultrasonography，Computed Tomog r aphy(CT)，biopsy were performed.Results In those with abnormal AFP level，1 week after RF treatment,AFP falled to normal in 119/153(77.8%) patient s；2～4 weeks later or after the second treatment,AFP droped to normal in 144/15 3 (94.1%) patients；lesions showed no enlargement in size and/or decreased in si ze or liquified at computed tomography and/or ultrasonography.The biopsy r es ults of the treated lesions showed necrosis accompanied by microvessel em bolism.In 121/142(85.2%) patients，the abdomen pain vanished and in the other p atients abdomen pain relieved after treatment.Ascites occured in 26/180(14.4)， temporary jaundice occured in 16/180(8.9%) patients after RF therapy.C onclusion RF ablation appears to be a less-invasive，safe and effectiv e treatment for primary and s[1] [2] 下一页
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