中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2014年
11期
939-943
,共5页
蒋天安%陈立斌%陈芬%赵齐羽
蔣天安%陳立斌%陳芬%趙齊羽
장천안%진립빈%진분%조제우
超声检查%肝肿瘤%射频消融术%并发症
超聲檢查%肝腫瘤%射頻消融術%併髮癥
초성검사%간종류%사빈소융술%병발증
Ultrasonography%Liver neoplasms%Radiofrequency ablation%Complications
目的:评估超声引导下射频消融(radiofrequency ablation ,RFA )治疗肝恶性肿瘤的安全性。方法回顾性分析2012年1月至2014年2月在超声引导下行肝恶性肿瘤射频消融患者临床资料,以及术后1~3个月随访影像学资料,统计分析肝恶性肿瘤射频消融相关严重并发症及轻微并发症的情况。结果900例肝恶性肿瘤患者共行1080次RFA治疗,消融病灶数为1568个,病灶直径平均为(26.±12.)cm。RFA并发症发生率为59.3%(64/1080),其中严重并发症发生率为19.4%(21/1080),轻微并发症发生率为39.8%(43/1080)。并发症包括腹腔出血27.8%(30/1080),肝脓肿07.4%(8/1080),胆道损伤06.4%(7/1080),大血管损伤05.6%(6/1080),针道种植转移04.6%(5/1080),胸腔出血03.7%(4/1080),胃肠道损伤01.8%(2/1080),肝性脑病0.09%(1/1080),因肝癌破裂出血后肝功能衰竭死亡0.09%(1/1080)。984.%(63/64)的并发症患者经过包括保守治疗、输血、消融止血、手术、置管引流以及肝移植等治疗后好转。结论超声引导下RFA治疗肝恶性肿瘤是一种安全微创的方法,但应注意潜在的严重并发症,仍需掌握好RFA的治疗指征。
目的:評估超聲引導下射頻消融(radiofrequency ablation ,RFA )治療肝噁性腫瘤的安全性。方法迴顧性分析2012年1月至2014年2月在超聲引導下行肝噁性腫瘤射頻消融患者臨床資料,以及術後1~3箇月隨訪影像學資料,統計分析肝噁性腫瘤射頻消融相關嚴重併髮癥及輕微併髮癥的情況。結果900例肝噁性腫瘤患者共行1080次RFA治療,消融病竈數為1568箇,病竈直徑平均為(26.±12.)cm。RFA併髮癥髮生率為59.3%(64/1080),其中嚴重併髮癥髮生率為19.4%(21/1080),輕微併髮癥髮生率為39.8%(43/1080)。併髮癥包括腹腔齣血27.8%(30/1080),肝膿腫07.4%(8/1080),膽道損傷06.4%(7/1080),大血管損傷05.6%(6/1080),針道種植轉移04.6%(5/1080),胸腔齣血03.7%(4/1080),胃腸道損傷01.8%(2/1080),肝性腦病0.09%(1/1080),因肝癌破裂齣血後肝功能衰竭死亡0.09%(1/1080)。984.%(63/64)的併髮癥患者經過包括保守治療、輸血、消融止血、手術、置管引流以及肝移植等治療後好轉。結論超聲引導下RFA治療肝噁性腫瘤是一種安全微創的方法,但應註意潛在的嚴重併髮癥,仍需掌握好RFA的治療指徵。
목적:평고초성인도하사빈소융(radiofrequency ablation ,RFA )치료간악성종류적안전성。방법회고성분석2012년1월지2014년2월재초성인도하행간악성종류사빈소융환자림상자료,이급술후1~3개월수방영상학자료,통계분석간악성종류사빈소융상관엄중병발증급경미병발증적정황。결과900례간악성종류환자공행1080차RFA치료,소융병조수위1568개,병조직경평균위(26.±12.)cm。RFA병발증발생솔위59.3%(64/1080),기중엄중병발증발생솔위19.4%(21/1080),경미병발증발생솔위39.8%(43/1080)。병발증포괄복강출혈27.8%(30/1080),간농종07.4%(8/1080),담도손상06.4%(7/1080),대혈관손상05.6%(6/1080),침도충식전이04.6%(5/1080),흉강출혈03.7%(4/1080),위장도손상01.8%(2/1080),간성뇌병0.09%(1/1080),인간암파렬출혈후간공능쇠갈사망0.09%(1/1080)。984.%(63/64)적병발증환자경과포괄보수치료、수혈、소융지혈、수술、치관인류이급간이식등치료후호전。결론초성인도하RFA치료간악성종류시일충안전미창적방법,단응주의잠재적엄중병발증,잉수장악호RFA적치료지정。
Objective To evaluate the safety of percutaneous radiofrequency ablation (RFA ) in hepatic malignant tumors under the guidance of ultrasonography .Methods The clinical data and the follow‐up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA between January 2012 and February 2014 were retrospectively reviewed ,and the major or minor complications of RFA were both calculated .Results 1 568 lesions were ablated by 1 080 percutaneous RFA procedures in 900 patients with hepatic malignant tumors under the guidance of the sonography .The average size of the tumors was (2 6.± 1 2.)cm .The total complications rate of 1 080 RFA procedures was 5 9.3% (64/1 080) , which including intra‐abdominal bleeding 2 7.8% (30/1 080) ,hepatic abscess 0 7.4% (8/1 080) ,biliary tract damage 0 6.4% (7/1 080 ) ,vascular damage 0 5.6% (6/1 080 ) ,tract seeding 0 4.6% (5/1 080 ) ,pleural hemorrhage 0 3.7% (4/1 080) ,gastrointestinal damage 0 1.8% (2/1 080) ,hepatic encephalopathy 0 0.9% (1/1 080) ,and death 0 0.9% (1/1 080) .While major complications was 1 9.4% (21/1 080) vs minor 3 9.8% (43/1 080) .Sixty three patients with complications recovered after treatments including blood transfusion , ablation ,surgery ,interventional drainage procedure and liver transplantation ,only one patient died for irreversible liver failure .Conclusions RFA for hepatic malignant tumors under the guidance of sonography is a safe method with lower complications rate ,however ,the potential major complications and the indications of RFA liver malignant tumors should be carefully focused on .