引用本文:姚思扬,杨福茂,陈元元,唐耘天,周燕秋,许春梅,刘天奇.超声引导射频消融联合无水酒精注射治疗特殊部位肝癌的效果观察[J].中国临床新医学,2017,10(5):410-412.
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超声引导射频消融联合无水酒精注射治疗特殊部位肝癌的效果观察
姚思扬,杨福茂,陈元元,唐耘天,周燕秋,许春梅,刘天奇
530021 南宁,广西壮族自治区人民医院肝胆外科(姚思扬,陈元元,唐耘天,周燕秋,刘天奇),超声科(杨福茂,许春梅)
摘要:
[摘要] 目的 探讨超声引导射频消融(RFA)联合无水酒精注射(PEI)治疗特殊部位肝癌的方法与疗效。方法 对进行了超声引导射频消融联合无水酒精注射治疗的41例特殊部位肝癌患者的49个瘤体的临床数据进行回顾性总结分析。49个瘤体的治疗方法:43个经皮超声引导PEI+RFA,3个腔镜超声引导PEI+RFA,3个开腹超声引导PEI+RFA。PEI+RFA的方法:超声引导实时监控下对肿瘤的RFA高危侧,即特殊部位侧进行至少5 mm以上的完整覆盖的PEI,然后对肿瘤行RFA治疗,RFA治疗的布针保持在特殊部位肿瘤内距离比邻器官或管道的5 mm处。疗效评价:术后一月进行肝脏超声造影或增强CT扫描评价术后消融率。结果 经皮PEI+RFA的43个瘤体的完全消融率为93.02%(40/43),腔镜及开腹PEI+RFA 6个瘤体的完全消融率均为100%(6/6),全部患者均无邻近器官损伤及腹腔大出血等严重并发症,部分患者有轻度的术后疼痛、低烧等轻微不良反应,无需特殊处理。全部患者治疗后7 d康复出院。结论 超声引导PEI+RFA可很好地解决特殊部位肝癌消融治疗的彻底性和安全性,是特殊部位肝癌的效果确切、安全可行的治疗方法。开腹和腹腔镜下消融可提高消融的彻底性。
关键词:  超声引导  肝癌  射频消融  无水酒精注射
DOI:10.3969/j.issn.1674-3806.2017.05.03
分类号:R 735.7
基金项目:广西科学研究与技术开发计划项目(编号:桂科攻1355005-3-15);广西科学研究与技术开发计划项目(编号:桂科攻1140003B-65)
RFA combined with PEI for primary liver cancer in special sites
YAO Si-yang, YANG Fu-mao, CHEN Yuan-yuan, et al
Department of Hepatobiliary Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To investigate the method and outcome of radiofrequency ablation(RFA) combined with percutaneous ethanol injection(PEI) for primary liver cancer(PLC) in special sits.Methods The data of 49 tumors in 41 patients with primary liver cancer in special sits treated with RFA combined with PEI were retrospectively analyzed.Results In the 49 tumors, 43 tumors were treated with percutaneous ultrasound-guided PEI+RFA, other 3 tumors were treated with laparoscopic ultrasound-guided PEI+RFA, and the rest 3 tumors were treated with laparotomy ultrasound-guided PEI+RFA. The outcomes of the treatments were evaluated by contrast-enhanced ultrasound or enhanced CT scanning one month after the ablation. The rate of the tumors ablated completely of percutaneous ultrasound-guided PEI+RFA was 93.02%(40/43). The rate of the other two methods was 100%(6/6). All the patients had no severe complications such as abdominal bleeding and adjacent organ injury, except some mild complications such as mild abdominal pain and fever. All the patients discharged from the hospital after the treatment of ablation.Conclusion Ultrasound-guided PEI+RFA is an effective, safe and feasible treatment method for the patients with liver cancer in special sits and laparotomy and laparoscopy can improve its therapeutic effect.
Key words:  Ultrasound-guided  Primary liver cancer  Radiofrequency ablation(RFA)  Percutaneous ethanol injection(PEI)