Ultrasound-guided percutaneous radiofrequency ablation of liver neoplasms:a clinical study
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摘要: 目的 研究在超声引导下经皮射频消融治疗肝肿瘤的临床应用价值,经过短期随访对该治疗方案对肿瘤的消除能力进行评价。 方法 分析绍兴市人民医院肿瘤科在2014年1月-2016年6月间进行肝肿瘤治疗的患者50例,均行超声引导下经皮射频消融进行治疗,进行为期3个月的随访调查,采用超声造影对消融后的病灶完全消融率、肿瘤标志物的升高率、并发症的发生情况进行评价。 结果 采用射频消融技术进行肝肿瘤治疗的总有效为86.0%,术后,经超声造影检查有43例(86.0%)的肿瘤为坏死,7例(14.0%)仍有残留,需要考虑二次消融术;50例肝肿瘤患者在术前有41例(82.0%)出现肿瘤标志物升高,术后有30例患者标志物降低,11例(22.0%)仍为AFP升高,术后2个月复查为6例(12.0%)有升高,二次消融后没有升高者;术中有7例患者出现疼痛,注射止痛药后有效的缓解了疼痛感,4例心率减慢,10例消融后综合征,总发生率为42.0%,没有出现严重并发症,术后有34例患者出现转氨酶升高。 结论 超声引导下经皮射频消融治疗肝肿瘤效果明确,有效消除肿瘤和残留,而且没有出现严重的并发症,安全可靠,超声引导提高了对肿瘤的诊断,对疾病的治疗有着很大的帮助,射频消融有效降低复发,消除残留,值得在肝肿瘤的治疗上推广使用。Abstract: Objective To study the clinical application of percutaneous radiofrequency ablation (FRA) under ultrasound guidance in the treatment of liver tumors. Methods The clinical data of 50 patients with liver neoplasms in our department from January,2014 to June,2016 were analyzed retrospectively.All patients underwent ultrasound guided percutaneous radiofrequency ablation for 3 months.The complete ablation rate of the lesion after ablation,the rate of increase of tumor markers,and the incidence of complications were evaluated. Results The total effective rate of radiofrequency ablation was 86.0%,and 43(86.0%) of the tumors were necrotic and 7(14.0%) of them were still remained after contrast-enhanced ultrasonography.Forty-one of 50 patients were with increased tumor markers before the surgery (82.0%).After the therapy,the levels of markers in 30 patients was reduced,11 patients (22.0%) was still with elevated AFP,6 cases (12.0%) still with elevated AFP 2 months later,however,there was cases with elevated AFP after the second ablation.After the operation,7 cases were with a pain and were relieved after the injection of analgesic;4 cases with the decrease in heart rate,10 patients (42.0%) with post-ablation syndrome.No serious complications occurred.Thirty-four patients had elevated transaminases after the operation. Conclusion Ultrasound-guided percutaneous radiofrequency ablation in the treatment of liver tumors is effective,safe and reliable,without serious complication.It can eliminate tumor tissue and the remains,reduce the relapse rate,and is worthy of promote in clinic.
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