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目的探讨经皮细刀头氩氦刀靶向冷冻治疗肝癌的有效性及安全性。方法从2006年6月至2007年6月,广东省佛山市第一人民医院在超声引导下采用Cryo-Hit氩氦刀1.47mm细刀头对26例原发性肝癌、15例复发性肝癌和13例转移性肝癌总共105个瘤灶(直径0.8~12.0cm)经皮靶向冷冻治疗。每3~6个月复查血清肿瘤标记物、B超、CT或MR评价瘤灶坏死情况,采用Kaplan-Meier统计分析存活率。结果原发性肝癌组、复发性肝癌组以及转移性肝癌组术后1年累积存活率分别为81.82%、46.22%和80.21%。术后复查B超、CT或MR均提示瘤灶不同程度的缩小甚至消失,对于直径<3cm的肿瘤完全坏死率达96.2%,直径3~5cm的肿瘤完全坏死率达90.6%,直径>5cm的肿瘤完全坏死率达28.6%。无出血、胆漏等严重并发症发生。结论超声引导经皮细刀头氩氦刀靶向冷冻治疗肝癌是继射频、微波之后又一安全、有效的经皮局部消融治疗新方法,其远期疗效还有待长期随访观察。
Objective To investigate the efficacy and safety of percutaneous fine-tip argon-helium cryoablation for the treatment of liver cancer. Methods From June 2006 to June 2007, First People’s Hospital of Foshan City, Guangdong Province, under the guidance of ultrasound guided Cryo-Hit argon-helium knife 1.47mm fine head of 26 cases of primary liver cancer, 15 cases of recurrent liver cancer and A total of 105 tumors (diameter 0.8 ~ 12.0cm) in 13 cases of metastatic liver cancer were treated with percutaneous targeted cryotherapy. Serum tumor markers were reviewed every 3 to 6 months, and tumor necrosis was evaluated by B-mode ultrasonography, computed tomography or MR imaging. Survival rate was analyzed by Kaplan-Meier statistics. Results The cumulative survival rates at 1 year after primary liver cancer, recurrent liver cancer and metastatic liver cancer were 81.82%, 46.22% and 80.21%, respectively. Postoperative recheck of B-ultrasound, CT or MR showed that the lesion shrinks or even disappears to varying degrees, with a complete necrosis rate of 96.2% for tumors <3 cm in diameter and 90.6% in tumors with a diameter of 3 to 5 cm, with a diameter of> 5 cm Complete tumor necrosis rate of 28.6%. No bleeding, bile leakage and other serious complications. Conclusion Ultrasonically guided cryoablation targeted cryoablation of hepatocellular carcinoma is another safe and effective new method of percutaneous local ablation after radiofrequency and microwave. Its long-term follow-up effect remains to be observed.