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目的总结分析经皮射频(PRFA)治疗肝脏肿瘤的并发症及患者康复特点。方法PRFA治疗肝脏肿瘤患者187例256个病灶,肿瘤直径1.5~15.0 cm,肝脏原发性及转移性恶性肿瘤157例,良性肿瘤30例。应用RF-2000射频仪和10电极LeVeen射频针,局部麻醉,B超引导下经皮肝穿刺治疗。随访观察患者术后康复特点、缓解率和并发症情况。结果PRFA操作均顺利完成。平均5.5 d后患者康复出院或接受其他治疗方案。并发症10例(5.3%),包括电极片灼伤皮肤(Ⅱ度)3例,腹水外渗皮下积水2例,胆漏(肝包膜下积聚胆汁)1例,腹腔出血1例,肝曲结肠穿孔1例,腹壁穿刺针道转移1例,急性胆囊炎1例。PRFA相关死亡1例(0.5%),该患者PRFA治疗后3 d死于脑梗死。肝脏恶性肿瘤患者PRFA治疗后随访率93.0%(146/157),随访期20~68个月,缓解率(CR+PR)为94.5%(138/146);患者1、2、3年生存率分别为95.9%(140/146)、75.0%(99/132)和40.8%(42/103)。肝脏良性肿瘤患者PRFA治疗后无并发症,均获得随访,缓解率100%。结论PRFA治疗肝脏肿瘤具有微创、有效、患者康复快等优势,其并发症可通过相应措施而有效防治。
Objective To summarize and analyze the complications of percutaneous radio frequency (PRFA) treatment of liver tumors and the characteristics of patients’ rehabilitation. Methods PRFA was used to treat 187 patients with liver lesions of 256 lesions, with a diameter of 1.5 ~ 15.0 cm. There were 157 primary and metastatic malignant tumors in liver and 30 benign tumors. Application of RF-2000 RF and 10 electrodes LeVeen RF needle, local anesthesia, B-guided percutaneous liver puncture. Follow-up observation of patients with postoperative recovery characteristics, response rates and complications. Results The PRFA operations were successfully completed. After 5.5 days, the patients were discharged or received other treatment programs. The complications included 10 cases (5.3%) including 3 cases of burned skin (Ⅱ degree), 2 cases of extraperitoneal subcutaneous hydrocephalus, 1 case of bile leakage (accumulation of bile under the capsule), 1 case of abdominal bleeding, 1 case of colon perforation, 1 case of needle puncture of abdominal wall and 1 case of acute cholecystitis. PRFA-related death in 1 case (0.5%), the patient died of cerebral infarction 3 days after PRFA treatment. The follow-up rate was 93.0% (146/157) after PRFA in patients with malignant liver tumors, and the response rate was 94.5% (138/146) after 20-68 months of follow-up. The 1, 2, 3 year survival rate 95.9% (140/146), 75.0% (99/132) and 40.8% (42/103), respectively. PRFA patients with benign liver tumor without complications, were followed up, the response rate was 100%. Conclusion PRFA treatment of liver tumors with minimally invasive, effective, rapid recovery of patients and other advantages, its complications can be effectively controlled by appropriate measures.