中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (12): 1022-1024.

• 论著 • 上一篇    下一篇

肝癌开腹射频治疗适应证选择研究

谢东辉，陈 剑，常志刚，宋京海，刘燕南，韦军民   

  1. 卫生部北京医院肝胆胰外科,北京100730
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-12-18 发布日期:2009-12-18

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-12-18 Published:2009-12-18

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摘要：

目的 探索开腹射频治疗在不可切除肝癌的治疗效果。方法 2006年5月至2008年11月引进Cool-tip冷循环超能射频治疗仪对不可切除肝癌（原发和转移）26例46个病灶在B超引导下施行了开腹射频消融（RFA）治疗，同期，经皮不可切除肝癌射频治疗17例。结果 所有病人得到随访，术后定期行AFP、B超和（或）CT 检查，最长随访时间28个月，最短1个月，平均12.8个月。术前AFP增高10例，术后3个月内全部恢复正常；1例CT发现可疑针道残留，3例随访过程出现肝脏新的转移灶； 1例RFA治疗后9d死于持续腹腔出血，1例肝切除+RFA治疗后30d死于腹腔出血和感染，2例于随访过程中死于多发转移（分别生存7个月、4个月）。结论 开腹B超引导的射频消融治疗与肝癌切除手术有机结合可以拓展肝癌外科治疗的范围，有利于提高肝癌的整体疗效。

关键词: 开腹射频消融, 不可切除肝癌

Abstract:

Radiofrequency ablation applied in unresectable liver cancer in laparotomy XIE Dong-hui, CHEN Jian, CHANG Zhi-gang, et al. Department of Hepatobiliary and Pancreatic Surgery, Beijing Hospital, Beijing 100730，China Corresponding author: CHEN Jian, E-mail: chendaoxian@sina.com Abstract Objective To investigate the effect of radiofrequency ablation（RFA）in treating unresectable liver cancer in laparotomy. Methods RFA in laparotomy was applied in the patients suffered from unresectable liver cancer from May 2006 to November 2008 at Beijing Hospital. Twenty-six patients (46 lesions) were treated with RFA in laprotomy. During the same period, 17 patients ( 32 lesions) were in percutaneous RFA. Results All the patients were followed up with AFP, abdominal B-ultrasound and CT scans for 1 to 28 months, and the average time is 12.8 moths. Increasing of preoperative AFP occurred in 10 patients and recovered in 3 months after operation. Forty-five lesions were ablated completely ( 97.8%,45/46) , and 1 patient was suspected having residual lesion in CT scan. Two patients were died of postoperative bleeding. Three patients were found new lesions on liver in CT scan. Two patients were died of multi-metastasis during following up. Conclusion RFA applied in laprotomy is an effective and safe method in patients suffered from unresectable liver cancer.

Key words: radiofrequency ablation, unresectable liver cancer