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目的评价内冷循环射频消融肝癌的临床应用价值。方法 63例患者,97个肿瘤结节(直径2.2～7.0cm),应用Radionics公司生产的脉冲式冷循环射频仪,能量输入为120～200 W,持续时间12～15 min,在超声引导下应用18G针尖裸露长度为2～3 cm的内冷循环电极针进行RFA治疗。每个肿瘤结节治疗1次或3次,新发现的结节再次行RFA治疗。结果肿瘤完全坏死率在3个月、6个月、12个月分别为80.8%、75.6%、63.1%。存活率在3个月、6个月、1年、2年、3年分别为98.4%、93.6%、85.7%、61.9%、58.7%。34例原发性肝癌AFP升高患者中,23例术后1～3个月降为正常。10例转移性肝癌中CEA术前增高,术后明显下降,均未降到正常,维持在20 ng/ml左右,所有患者临床症状改善,2例发生并发症。结论超声引导下经皮内冷循环消融肝癌是有效和安全的方法。
Objective To evaluate the clinical value of intra-cold cycle radiofrequency ablation of liver cancer. Methods Totally 97 patients with nodules (diameter 2.2 ~ 7.0cm) were treated with Radionics pulsed cold cycle radiofrequency instrument. The energy input was 120 ~ 200 W and the duration was 12 ~ 15 min. Ultrasound-guided 18G needle tip length of 2 ~ 3 cm internal cooling cycle electrode needle for RFA treatment. Each tumor nodule treated 1 or 3 times, the newly discovered nodules RFA treatment again. Results The complete tumor necrosis rate was 80.8%, 75.6% and 63.1% at 3 months, 6 months and 12 months respectively. The survival rates were 98.4%, 93.6%, 85.7%, 61.9% and 58.7% at 3 months, 6 months, 1 year, 2 years and 3 years respectively. Of the 34 patients with elevated AFP in primary liver cancer, 23 were normalized 1 to 3 months after surgery. In 10 cases of metastatic liver cancer, CEA increased preoperatively and decreased significantly after operation. All of them did not fall to normal level and remained at about 20 ng / ml. The clinical symptoms of all patients were improved and the complications occurred in 2 cases. Conclusion Ultrasound-guided percutaneous internal circulation ablation of liver cancer is an effective and safe method.