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目的研究在超声引导下经皮射频消融治疗肝肿瘤的临床应用价值,经过短期随访对该治疗方案对肿瘤的消除能力进行评价。方法分析绍兴市人民医院肿瘤科在2014年1月—2016年6月间进行肝肿瘤治疗的患者50例,均行超声引导下经皮射频消融进行治疗,进行为期3个月的随访调查,采用超声造影对消融后的病灶完全消融率、肿瘤标志物的升高率、并发症的发生情况进行评价。结果采用射频消融技术进行肝肿瘤治疗的总有效为86.0%,术后,经超声造影检查有43例(86.0%)的肿瘤为坏死,7例(14.0%)仍有残留,需要考虑二次消融术;50例肝肿瘤患者在术前有41例(82.0%)出现肿瘤标志物升高,术后有30例患者标志物降低,11例(22.0%)仍为AFP升高,术后2个月复查为6例(12.0%)有升高,二次消融后没有升高者;术中有7例患者出现疼痛,注射止痛药后有效的缓解了疼痛感,4例心率减慢,10例消融后综合征,总发生率为42.0%,没有出现严重并发症,术后有34例患者出现转氨酶升高。结论超声引导下经皮射频消融治疗肝肿瘤效果明确,有效消除肿瘤和残留,而且没有出现严重的并发症,安全可靠,超声引导提高了对肿瘤的诊断,对疾病的治疗有着很大的帮助,射频消融有效降低复发,消除残留,值得在肝肿瘤的治疗上推广使用。
Objective To study the clinical value of percutaneous radiofrequency ablation (RFA) guided by ultrasound in the treatment of hepatic tumors and to evaluate the efficacy of this treatment on tumor elimination after short-term follow-up. Methods Fifty patients with hepatocarcinoma who underwent oncology in Department of Oncology, People’s Hospital of Shaoxing from January 2014 to June 2016 were treated by percutaneous radiofrequency ablation guided by ultrasound and followed up for 3 months. CEUS was used to evaluate the complete ablation rate of ablated lesions, the rate of tumor marker increase and the incidence of complications. Results The total effective rate of radiofrequency ablation for the treatment of liver cancer was 86.0%. After the operation, 43 (86.0%) of the tumors were necrotic by ultrasound contrast and 7 (14.0%) remained residual after radiofrequency ablation. (N = 50). Totally, 41 patients (82.0%) had tumor markers in 50 patients with liver cancer. Thirty patients showed decreased markers after surgery. Eleven patients (22.0%) still had elevated AFP, Month review was 6 cases (12.0%) were elevated, no increase after secondary ablation; surgery in 7 patients with pain, injection of painkillers effectively relieve pain, 4 patients with heart rate slowed down, 10 patients Post-ablation syndrome, the overall incidence was 42.0%, no serious complications, 34 patients after surgery, elevated transaminases. Conclusion Ultrasound-guided percutaneous radiofrequency ablation of liver tumors clear effect, effectively eliminate the tumor and residual, and no serious complications, safe and reliable, ultrasound guided to improve the diagnosis of the disease, the treatment of diseases is of great help, Radiofrequency ablation effectively reduce recurrence, eliminate residual, it is worth in the promotion of the use of liver tumors.