CAJ | 학술논문

目的：探讨肝恶性肿瘤经皮热消融治疗的胸膈并发症发生原因及防治措施。方法以接受热消融治疗的1520例患者作为研究对象,回顾性分析经皮热消融治疗肝恶性肿瘤的胸膈并发症。结果1520例患者2789个肿瘤共行2066例次热消融治疗,射频消融(RFA)治疗506例次,微波消融(MWA)治疗1560例次,肿瘤最大直径0.5~6.0 cm,平均(2.30±1.03)cm。1个月增强 CT/MRI 检查,肿瘤完全消融率96.8%(2701/2789)。治疗后17例出现严重胸膈并发症,发生率为0.8%。134例出现轻微并发症,发生率6.5%。结论经皮热消融治疗肝恶性肿瘤的胸膈并发症发生率低,但严重并发症可能导致严重后果,对邻近膈肌的危险部位肿瘤治疗前要充分评估,做好预防措施,必要时采用开腹或腹腔镜辅助治疗。
목적：탐토간악성종류경피열소융치료적흉격병발증발생원인급방치조시。방법이접수열소융치료적1520례환자작위연구대상,회고성분석경피열소융치료간악성종류적흉격병발증。결과1520례환자2789개종류공행2066례차열소융치료,사빈소융(RFA)치료506례차,미파소융(MWA)치료1560례차,종류최대직경0.5~6.0 cm,평균(2.30±1.03)cm。1개월증강 CT/MRI 검사,종류완전소융솔96.8%(2701/2789)。치료후17례출현엄중흉격병발증,발생솔위0.8%。134례출현경미병발증,발생솔6.5%。결론경피열소융치료간악성종류적흉격병발증발생솔저,단엄중병발증가능도치엄중후과,대린근격기적위험부위종류치료전요충분평고,주호예방조시,필요시채용개복혹복강경보조치료。
Objective To explore the thoracic and diaphragmatic complications of treating hepatic malignant tumor using thermal ablation techniques.Methods The patients received thermal ablations were involved as subjects from January 2002 to December 2013.The thoracic and diaphragmatic complications of treating hepatic malignant tumor with percutaneous thermal ablation were retrospectively analyzed.Results A total of 1 520 patients with 2 789 hepatic tumors [average largest diameter of tumor (2.30 ± 1 .03)cm] underwent 2 066 thermal ablation treatments.Five hundred and six radiofrequency ablation (RFA)and 1 560 microwave ablation procedures were performed,respectively.The complete ablation rate was 96.8%(2 701/2 789)at 1 month after treatment.The major thoracic and diaphragmatic complication rates were 0.8%(1 7/2 066 ),meanwhile the minor complication rates were 6.5% (134/2 066 ).Conclusions The thoracic and diaphragmatic complication rate of percutaneous thermal ablation is low in the treatment of hepatic malignant tumors.However,the major complications may cause serious consequences.Therefore, the patients of diaphragm-abutting liver tumors are fully assessed before thermal ablation treatments,and relevant prevention measures are completed.Open or laparoscope is used to assist thermal ablation treatment when necessary.