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人工腹水辅助超声引导射频消融治疗膈顶部原发性肝癌

卢景宁, 杨红, 彭民浩, 肖开银, 彭涛, 彭金波

卢景宁, 杨红, 彭民浩, 肖开银, 彭涛, 彭金波. 人工腹水辅助超声引导射频消融治疗膈顶部原发性肝癌[J]. 肿瘤防治研究, 2015, 42(05): 493-497. DOI: 10.3971/j.issn.1000-8578.2015.05.016
引用本文: 卢景宁, 杨红, 彭民浩, 肖开银, 彭涛, 彭金波. 人工腹水辅助超声引导射频消融治疗膈顶部原发性肝癌[J]. 肿瘤防治研究, 2015, 42(05): 493-497. DOI: 10.3971/j.issn.1000-8578.2015.05.016
LU Jingning, YANG Hong, PENG Minhao, XIAO Kaiyin, PENG Tao, PENG Jinbo. Percutaneous Ultrasound-guided Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in Hepatic Dome[J]. Cancer Research on Prevention and Treatment, 2015, 42(05): 493-497. DOI: 10.3971/j.issn.1000-8578.2015.05.016
Citation: LU Jingning, YANG Hong, PENG Minhao, XIAO Kaiyin, PENG Tao, PENG Jinbo. Percutaneous Ultrasound-guided Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in Hepatic Dome[J]. Cancer Research on Prevention and Treatment, 2015, 42(05): 493-497. DOI: 10.3971/j.issn.1000-8578.2015.05.016

人工腹水辅助超声引导射频消融治疗膈顶部原发性肝癌

基金项目: 国家自然科学基金(81060202,81260222);中国肝炎防治基金会天晴肝病研究基金课题(TQGB2011021);广西卫生厅重点课题(重2011089);广西卫生厅课题(Z2011324)
详细信息
    作者简介:

    卢景宁(1979-),男,博士,主治医师,主要从事肝移植及临床肝胆外科工作

    通信作者:

    杨红,E-mail:yanghonggx@163.com

  • 中图分类号: R735.7

Percutaneous Ultrasound-guided Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in Hepatic Dome

  • 摘要: 目的 探讨人工腹水辅助超声引导射频消融(radiofrequency ablation, RFA)治疗膈顶部肝细胞癌(hepatocellular carcinoma, HCC)的可行性、安全性及临床应用价值。方法 回顾性分析2010年1月至2012年12月间于广西医科大学第一附属医院行人工腹水辅助超声引导RFA治疗膈顶部HCC的22例患者25个病灶的临床资料,参照Seldinger穿刺技术并进行改进,用5-F动脉鞘管置入肝与腹膜之间的膈顶部建立人工腹水,使得膈顶部肿瘤显示清楚或穿刺路径完全暴露。并对人工腹水辅助下射频消融治疗的成功率、安全性进行分析。结果 本组88.0%(22/25)病例成功建立人工腹水,膈顶部病灶位置及范围得以完全显示并显示穿刺路径。所有患者注入的人工腹水均于术后3天内完全自行吸收。本组未发生腹腔内出血、腹膜炎、血胸、气胸等严重的并发症,无手术相关死亡病例。术后一月增强CT/MR随访复查提示所有病灶消融完全,无肿瘤局部残留。结论 建立人工腹水后可使得原位于超声盲区无法进行RFA治疗的膈顶部肿瘤得以清楚显示,拓宽了RFA治疗适应证;人工腹水辅助超声引导射频消融治疗膈顶部HCC安全、简易、可行,有较高临床应用价值。

     

    Abstract: Objective To investigate the feasibility, efficacy, and safety of percutaneous ultrasound-guided radiofrequency ablation(RFA) with artificial ascites for hepatocellular carcinoma(HCC) in the hepatic dome. Methods We retrospectively analyzed the clinical data of 22 patients with HCC in the hepatic dome with 25 lesions underwent percutaneous ultrasound-guided RFA with artificial ascites from January 2010 to December 2012. We used Seldinger technique to artificially induce ascites before RFA to improve tumor visibility or electrode path and to separate the RFA zone from the diaphragm. We assessed the technical feasibility, safety and efficacy of this technique in clinic. Results RFA was successfully performed in 88.0% (22/25) lesions after artificial ascites was achieved. There was substantial improvement in the visibility of partially visible tumors and in achieving a better path of the tumors with a poor electrode path. All patients showed complete absorption of artificial ascites after 3-day follow-up ultrasound. There was no patient showed any serious complications such as hemoperitoneum, peritonitis, hemothorax or pneumothorax. All tumors were completed ablation and there was no residual tumor after 1-month follow-up by CECT/MRI. Conclusion Establishment of artificial ascites could make HCC in the hepatic dome clearly displayed by ultrasound and broaden the indications of percutaneous RFA treatment. Percutaneous RFA with artificial ascites appears to be a feasible, safe and effective technique for treating HCC in the hepatic dome.

     

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出版历程
  • 收稿日期:  2014-11-19
  • 修回日期:  2014-12-18
  • 刊出日期:  2015-05-24

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