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目的 研究射频技术肝癌原位灭活治疗的方法及疗效。方法 在B超引导下将中空金属钛多极穿刺针经皮直接穿刺置入瘤体 ,分点 1次或多次对瘤体进行射频热毁损治疗。射频输出功率由 2 0W每隔一分钟增加 2 0W ,直至 90W ,治疗时间设定为 15分钟 ,术后观察病人的AFP、B超 (瘤体大小、回声、血流 )、CT图像及病理变化。结果 180例病人中AFP高于正常者 (15 3例 )射频治疗 1周后复查 119/15 3(77 8% )下降为正常 ;2～ 4周和部份治疗不完善者经过第 2次治疗后 144 /15 3(94 1% )下降为正常 ;B超和CT图像上表现为肿瘤无增大、缩小或液化 ,瘤体多普勒观察瘤体内无血流信号 ;术后病理学复查示治疗区为坏死组织伴血管栓塞 ,142例病人术前伴疼痛 ,治疗后 12 1/142 (85 2 % )疼痛消失 ,其余疼痛缓解。术后 2 6 /180 (14 4% )的病人出现腹水、一过性黄疸 16 /180 (8 9% )。结论 射频原位灭活是创伤小、疗效快、安全、有效的肝癌治疗方法。
Objective To study the method and efficacy of radio-frequency in situ inactivation of hepatocellular carcinoma (HCC). Methods Under the guidance of B-ultrasound, a hollow titanium multi-pole needle puncture needle into the tumor by percutaneous directing, one or more times on the tumor radiofrequency ablation treatment. The RF output power was increased from 20W every other minute to 20W until 90W, and the treatment time was set at 15 minutes. The postoperative AFP, B ultrasound (tumor size, echo, blood flow), CT images and pathological changes . Results 180 cases of patients with AFP higher than normal (153 cases) after 1 week of radiofrequency treatment review 119/15 3 (77 8%) decreased to normal; 2 to 4 weeks and some of the imperfect treatment after the second treatment After 144/15% (94.1%) decreased to normal; B ultrasound and CT images showed no tumor enlargement, shrinkage or liquefaction, tumor Doppler observation of tumor-free flow signal; postoperative pathological review The treatment area was necrotic tissue with vascular embolism, and 142 patients had preoperative pain. After treatment, 12 1/142 (85.2%) pain disappeared and the remaining pain relief. Ascites was present in 26 of 180 (14.4%) patients and 16/180 (89%) of transient jaundice. Conclusion RF in situ inactivation is a less traumatic, effective, safe and effective treatment of liver cancer.