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目的:探讨腹腔镜射频消融术(laparoscopic radiofrequency ablation,LRFA)治疗小肝癌(2 cm<直径≤5 cm)的临床应用价值。方法:采用LRFA治疗5例(7个瘤体)小肝癌患者,肿瘤位于肝脏Ⅱ、Ⅴ、Ⅷ段,Child-Pugh肝功能分级为Child A级或B级,术中超声准确定位后行LRFA;治疗后3周复查超声造影及甲胎蛋白,以判断其疗效。结果:术后5例患者均未出现复发或远处转移,且术中LRFA超过肿瘤范围1.0~2.5 cm,甲胎蛋白下降显著。结论:LRFA对小肝癌的治疗效果确切、可靠,对瘤体位于较大胆道系统尤其合并门静脉高压症患者安全、有效,可作为治疗小肝癌的选择方法之一。
Objective: To investigate the clinical value of laparoscopic radiofrequency ablation (LRFA) in the treatment of small hepatocellular carcinoma (2 cm <5 cm in diameter). Methods: Five patients (7 tumors) with small hepatic carcinoma were treated with LRFA. The tumors were located in the second, fifth and eighth segments of the liver. Child-Pugh liver function was graded as Child A or B, Three weeks after treatment, ultrasound contrast and alpha-fetoprotein were reviewed to determine their efficacy. Results: No recurrence or distant metastasis occurred in all the 5 patients. The intraoperative LRFA exceeded the tumor range of 1.0-2.5 cm, and the level of alpha fetoprotein decreased significantly. CONCLUSION: LRFA is effective and reliable for the treatment of small hepatocellular carcinoma. It is safe and effective for patients with large biliary tract and especially complicated with portal hypertension. LRFA can be used as one of the methods to treat small hepatocellular carcinoma.