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目的评价经皮射频(PRFA)联合肝动脉导管化疗栓塞术(TACE)治疗大肝癌的疗效。方法应用RF-2000射频仪和10电极LeVeen射频针经皮穿刺热消融治疗76例大肝癌患者81个病灶(肿瘤直径5.1~15.0cm),PRFA前后联合TACE治疗,随访观察治疗效果、并发症和患者生存情况。结果PRFA操作均顺利完成。并发症6.58%(5/76),包括电极片灼伤皮肤2例,胆漏1例,腹腔出血1例,急性胆囊炎1例。PRFA相关死亡1例,该患者PRFA治疗后3天死于脑梗死。TACE无并发症。随访16~62个月,随访率92.1%,患者血清AFP下降89.3%,缓解率98.6%,6个月、1年、3年生存率分别为98.6%、72.9%和30.6%。结论PRFA联合TACE能发挥互补增益作用,是治疗大肝癌的一种有效备选方案。
Objective To evaluate the efficacy of percutaneous radiofrequency (PRFA) combined with transcatheter arterial chemoembolization (TACE) in the treatment of large hepatocellular carcinoma. Methods Totally 76 lesions of major hepatocellular carcinoma (tumor diameter 5.1 ~ 15.0cm) were treated with RF-2000 radiofrequency instrument and 10-electrode LeVeen radiofrequency ablation. TACE before and after PRFA was followed up. Survival of patients. Results The PRFA operations were successfully completed. The complications were 6.58% (5/76), including 2 cases of skin electrode burn, 1 case of bile leakage, 1 case of intraperitoneal hemorrhage and 1 case of acute cholecystitis. PRFA-related death in 1 case, the patient died of cerebral infarction 3 days after PRFA treatment. TACE no complications. The follow-up ranged from 16 to 62 months. The follow-up rate was 92.1%. The serum AFP level decreased 89.3% and the response rate was 98.6%. The 6-month, 1-year and 3-year survival rates were 98.6%, 72.9% and 30.6%, respectively. Conclusions PRFA combined with TACE can play a role of complementary gain, is an effective alternative for the treatment of large liver cancer.