经皮肝穿刺射频消融术治疗肝癌

目的探讨经皮肝穿刺射频消融术(PRFA)治疗肝癌的疗效、适应证与并发症。方法在B超引导下,对54例肝癌患者行65例次PRFA治疗,对治疗后肝功能、甲胎蛋白(AFP)、肿瘤血供的变化、并发症及预后进行观察。结果28例PRFA治疗前AFP升高者有86%(24/28)的患者AFP有不同程度的下降;术后1~48个月MRI或CT复查提示83%(46/54)的患者肿瘤血供明显减少或消失,肿瘤≤3 cm者完全凝固性坏死率81%(26/32);术中术后并发症发生率17%(9/54);患者1 a生存率为91%,2 a生存率为76%。结论PRFA治疗肝癌具有微创、安全、有效等优点,特别适用于不能耐受手术切除且直径≤3 cm的肿瘤。

Clinical evaluation of percutaneous radiofrequeney ablation in treatment of hepatic carcinoma

Objective It is to approach the curative effect and safety of percutaneous radiofrequency ablation(PRFA) in treatment of hepatic carcinoma.Methods 54 cases were performed PRFA under ultrasound guidance,the PRFA frequency was 65 times.After treatment,the index of hepatic function,alpha fetoprotein(AFP) and blood signals around the tumors were examined,and the complications and prognosis were observed.Results 54 patients were treated with PRFA smoothly.AFP level was decreased in 86% patients with abnormal AFP level before PRFA.Blood signals around the tumors were decreased or disappeared in 83% of patients,complete necrosis rate of hepatic carcinoma with less than 3cm in diameter was 81%(26/32).The incidence rate of complication was 17%.The survival rate in one year was 91%,and the survival rate in two years was 76%.Conclusion PRFA is a safe,micro-wounded,effective method in treating hepatic carcinoma,especially for the patients who have no operation indication and the tumor size less than 3cm in diameter.