CAJ | 학술논문

目的探讨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)43例78个病灶在B超引导下施行了射频消融治疗.其中开腹单纯射频治疗15例,开腹肝癌切除+射频6例,开腹射频+乙醇注射5例,经皮射频治疗17例.均按需一次单针多点顺次穿刺布针方法完成,最多布针5针,平均2.1针;单灶最大径7 cm,平均2.5 cm;单例最多病灶6个,平均1.8个.结果所有患者均经CT和B超或MRI诊断,其中原发性肝癌18例,原发性肝癌切除术后复发12例,转移癌13例;43例全部得到随访,术后定期甲胎蛋白、B超和(或)CT检查,最长随访时间28个月,最短1个月,平均13.6个月.术前AFP增高20例,术后3个月内全部恢复正常;2例CT发现可疑针道和周缘残留,6例随访过程出现肝脏新的转移灶;1例经皮射频消融治疗后出现胃肠道瘘入皮下,并于3月后死于多发转移;1例死于开腹射频消融治疗后持续腹腔出血,1例死于开腹肝切除+射频消融治疗后腹腔出血和感染,3例于随访过程中死于多发转移(该3例平均生存时间6个月).结论 B超引导的冷循环射频消融治疗操作简便、易于掌握,患者痛苦小、恢复快,是一种有效安全的肝癌局部治疗方法 ,可以作为切除手术的重要辅助手段推广应用.
목적 탐토사빈치료재불가절제간암적치료효과.방법 2006년5월지2008년11월인진Cool-tip랭순배초능사빈치료의대불가절제간암(원발화전이)43례78개병조재B초인도하시행료사빈소융치료.기중개복단순사빈치료15례,개복간암절제+사빈6례,개복사빈+을순주사5례,경피사빈치료17례.균안수일차단침다점순차천자포침방법 완성,최다포침5침,평균2.1침;단조최대경7 cm,평균2.5 cm;단례최다병조6개,평균1.8개.결과 소유환자균경CT화B초혹MRI진단,기중원발성간암18례,원발성간암절제술후복발12례,전이암13례;43례전부득도수방,술후정기갑태단백、B초화(혹)CT검사,최장수방시간28개월,최단1개월,평균13.6개월.술전AFP증고20례,술후3개월내전부회복정상;2례CT발현가의침도화주연잔류,6례수방과정출현간장신적전이조;1례경피사빈소융치료후출현위장도루입피하,병우3월후사우다발전이;1례사우개복사빈소융치료후지속복강출혈,1례사우개복간절제+사빈소융치료후복강출혈화감염,3례우수방과정중사우다발전이(해3례평균생존시간6개월).결론 B초인도적랭순배사빈소융치료조작간편、역우장악,환자통고소、회복쾌,시일충유효안전적간암국부치료방법 ,가이작위절제수술적중요보조수단추엄응용.
Objective To investigate the effect of radiofrequency ablation (RFA) in treating unresectable liver caneer. Methods 43 patients(78 lesions) who suffered from unresectable liver cancer were treated with cool-tip RFA from May 2006 to November,2008 in our hospital. 26 cases were treated with RFA in laparotomy besides with reseet of lesion in 6 eases and with alinjection in 5 cases,while 17 eases were treated only with percutaneous RFA. Results All patients were diagnosed by CT and B-ultrasound or MRI,among whom 18 cases were confirmed with primary hepatic carcinoma, 12 eases experienced recurrence following resect of primary hepatic carcinoma and 13 eases developed metastatic carcinoma;Every patient was followed up with AFP, abdominal B-ultrasound, CT scans or MRI from 1 to 28 months after treatment (mean 13.6 months). Before procedure, AFP increased in 20 eases which recovered within 3 months of treatment. 2 cases were suspected having residual on CT scan ,6 cases were found with new masses on liver on CT scan, 1 case complicated with gastrointestinal fistula and then died of systemie metas-tasis 3 months later,1 ease died of postoperative bleeding and 1 died of bleeding and infection after reseet + RFA treatment,and 3 cases died of multi-metastasis during following up who survived on average of 6 months. Conclu-sions B-ultrasound -guided cool-tip circulation RFA is an effective and safe method in treating unresectable liver cancer.