CAJ | 학술논문

目的观察氩氦刀治疗5 cm以内原发肝癌或肝转移瘤的疗效.方法收集5 cm以内原发肝癌或肝转移瘤患者31例,共39个病灶.所有患者均于CT或超声等影像引导下接受氩氦刀治疗.结果肿瘤消融范围为90%～100%,完全消融病灶占69.23%(27/39).1年和2年存活率分别为90.32%(28/31)、61.29%(19/31).31例患者均无出血等严重并发症,术中寒战4例(12.90%);肝区疼痛6例(19.36%),重度疼痛1例,体表皮肤温度触冰感,CT扫描无出血迹象,生命体征稳定,给予强痛定止痛,效果差,术后2 h疼痛缓解,其余疼痛患者均为中、轻度疼痛,未予处置;术后发热7例(22.58%),体温37.12～38.25℃;无血管、胆管损伤病例;冷冻术后患者的精神状态得到改善,腹部疼痛症状减轻,恢复较快.结论对于不能手术切除的小肝癌和肝转移瘤,氩氦刀消融治疗安全性高、疗效可靠.
목적 관찰아양도치료5 cm이내원발간암혹간전이류적료효.방법 수집5 cm이내원발간암혹간전이류환자31례,공39개병조.소유환자균우CT혹초성등영상인도하접수아양도치료.결과 종류소융범위위90%～100%,완전소융병조점69.23%(27/39).1년화2년존활솔분별위90.32%(28/31)、61.29%(19/31).31례환자균무출혈등엄중병발증,술중한전4례(12.90%);간구동통6례(19.36%),중도동통1례,체표피부온도촉빙감,CT소묘무출혈적상,생명체정은정,급여강통정지통,효과차,술후2 h동통완해,기여동통환자균위중、경도동통,미여처치;술후발열7례(22.58%),체온37.12～38.25℃;무혈관、담관손상병례;냉동술후환자적정신상태득도개선,복부동통증상감경,회복교쾌.결론 대우불능수술절제적소간암화간전이류,아양도소융치료안전성고、료효가고.
Objective To observe the efficacy of percutaneous hepatic cryoablation for the treatment of primary or meta-static hepatic malignancies (<5 cm in diameter).Methods A total of 31 patients (39 tumors <5 cm in diameter) were treated with argon-helium cryoablation system under the guidance of CT or ultrasound.Results Tumor ablation range was 90%-100% in 39 lesions,including 69.23% (27/39) complete ablation.The 1- and 2-year survival rate was 90.32% (28/31) and 61.29% (19/31),respectively.No bleeding and injury of blood vessel or bile duct was noted.Complications of cryoablation included intraoperative shivering in 4 (12.90%) patients,postoperative fever (37.12-38.25℃ in 7 (22.58%) patients and hepatic pain in 6 (19.36%) patients.One patient had severe pain relief until 2 h after cryosurgery with ice-cold skin temperature and stable life index,analgesic had little effect,and no bleeding was found on CT image.Other patients had slight or moderate pain and remained untreated.Conclusion Percutaneous targeted argon-helium cryoablation is a feasible and safe technique in the treatment of small primary or metastatic hepatic malignancies not suitable for resection.