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目的 探讨超声导引经皮多弹头射频切除转移性肝癌的临床研究价值。方法 治疗 16例转移性肝癌 30个结节 ,共施行 2 0次 48个不同方向 12 8点射频切除 ,平均每例施行 1.2次 3个不同方向 8点射频切除。结果 彩超显示 93.75 % ( 15 / 16 )的病例肿瘤内彩色血流消失 ,增强CT扫描显示 10 0 % ( 16 / 16 )的病例肿瘤呈低密度或极低密度改变、无强化。免疫学指标检测CD3 75 % ( 12 / 16 )、CD4 87.5 % ( 14 / 16 )增高 ,CD86 8.75 % ( 11/ 16 )降低 ,CD4 /CD887.5 % ( 14 / 16 )增高。体重增加 87.5 % ( 14 / 16 ) ,其中 43.75 % ( 7/ 16 )增加 5 %以上。 1年复发率为 18.75 % ( 3/ 16 )。结论 超声导引经皮多弹头射频切除转移性肝癌能使瘤体绝大部分完全凝固坏死 ,明显提高患者的细胞免疫功能 ,是一种疗效肯定、并发症少、副反应轻、患者易接受的微创介入治疗技术和自身特异性主动免疫治疗。
Objective To investigate the clinical value of ultrasound-guided percutaneous multi-warhead radiofrequency ablation of metastatic liver cancer. Methods Thirty nodules of 16 patients with metastatic hepatocellular carcinoma were treated with radiofrequency ablation in 48 different directions 12 8 times. On average, 1.2 radiofrequency ablations were performed in 3 different directions and 8 points. Results Color Doppler showed that 93.75% (15/16) cases of color blood flow disappeared within the tumor. Enhanced CT scan showed that 10% (16/16) of the cases showed low density or very low density changes, no enhancement. Immunological markers detected CD3 75% (12/16), CD4 87.5 % (14/16) increased, CD86 8.75 % (11/16) decreased, and CD4/CD887.5 % (14/16) increased. Weight gain increased by 87.5% (14/16), with 43.75% (7/16) increasing by more than 5%. The 1-year recurrence rate was 18.75% (3/16). Conclusion Ultrasound-guided percutaneous multi-warhead radiofrequency ablation of metastatic liver cancer can completely coagulate and necrosis most of the tumor and significantly improve the patient’s cellular immune function. It is a positive effect, fewer complications, less side effects, and patients are easily accepted. Minimally invasive interventional therapy and its own specific active immunotherapy.