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目的 :评价射频毁损 (RFA)治疗原发性肝癌 (HCC)的近期疗效、安全性及并发症。方法 :采用RF - 2 0 0 0型射频治疗仪 ,在B超引导下经皮RFA治疗 96例HCC患者。结果 :96例HCC患者 (肝功能Child分级 :A级72例 ,B级 18例 ,C级 6例 )共 14 7个肿块 (平均直径 6 .6 0± 3.13cm ,1.9～ 15cm ,完成 12 0次治疗 ,平均治疗1.3次。CT证实 14例瘤体未彻底毁损 (平均直径 9.5 1± 2 .82cm ,5 .0～ 15cm) ,2例失访 ,80例瘤体完全毁损(平均直径 6 .0 9± 2 .0 2cm ,1.9～ 13.7cm) ,其中 78例平均随访 9.2月 (1～ 16月 ) ,4 3例复发 (5 5 .1% ) ,其中 2 3例肿瘤原位复发 (2 9.5 % )。 35例未见复发 (44 .9% )。多因素相关分析 ,原位复发与肿块直径呈显著正相关(P =0 .0 0 0 1)。 10例 (10 .4 % )发生并发症 ,无射频治疗相关的死亡。最常见的不良反应为吸收热 ;患者术后肝功能轻度损害 ,2周左右恢复至基线水平。结论 :经皮RFA是一种治疗HCC较安全有效的非手术方法 ,肿瘤直径是影响RFA疗效的主要因素。
Objective: To evaluate the short-term efficacy, safety and complications of radiofrequency ablation (RFA) in the treatment of primary liver cancer (HCC). Methods: 96 cases of HCC patients underwent transdermal RFA under the guidance of B - mode RF - 2000 RF radiotherapy instrument. Results: A total of 147 lumps (mean diameter 6.60 ± 3.13cm, 1.9 ~ 15cm) were obtained from 96 HCC patients (Child classification of liver function: 72 cases of A grade, 18 cases of B grade and 6 cases of C grade) In the second treatment, the average treatment time was 1.3.CT confirmed that the tumor was not completely destroyed in 14 cases (mean diameter was 9.5 ± 2.82cm, 5.0 ~ 15cm), 2 patients were lost to follow-up, and 80 tumors were completely destroyed (mean diameter 6). 78 cases were followed up for 9.2 months (from 1 month to 16 months) and 43 cases were recurrences (55.1%), of which 23 cases had recurrent tumors in situ (2 9.5%, 35 cases had no recurrence (44.9%) .Multivariate analysis showed that there was a significant positive correlation between in situ recurrence and tumor diameter (P = 0.0000) Complications occurred and no death related to radiofrequency therapy.The most common adverse reaction was heat of absorption.The patient suffered slight liver damage after surgery and returned to baseline level after 2 weeks.Conclusion: Percutaneous RFA is a safe and effective treatment of HCC The non-surgical method, tumor diameter is the main factor affecting the efficacy of RFA.