摘要
目的 分析CT引导下自制定位穿刺器械在肝脏肿瘤射频消融中的应用价值.方法 对2010年1月至2014年11月经射频消融治疗的64例原发性肝癌患者进行分析,共78个肿瘤灶,其中13个肿瘤直径3.5-5.0 cm,65个〈3.5 cm.在CT引导下应用自制定位穿刺器械进行肿瘤病灶的定位和穿刺,并利用肿瘤精确放射治疗计划系统对穿刺效果和病灶进行评估,采用肿瘤射频治疗系统对肿瘤病灶进行射频消融治疗.结果所有肿瘤在空间内的穿刺误差为1-4 mm,平均穿刺误差为2.9 mm,肿瘤病灶完全消融率达93.59%（73/78）,治疗过程中无严重并发症.治疗后患者的甲胎蛋白及肝功能均明显改善,与治疗前比较差异具有统计学意义（均P〈0.05）.术后1个月复查CT发现肿瘤及消融灶均无强化,术后3个月复查CT示所有肿瘤病灶动脉期未见强化,为低密度灶,全部消融未见复发.经过治疗后肿瘤1、2、3、4年的复发率为17.9%、29.9%、45.9%、55.0%.结论CT引导下自制定位穿刺器械射频消融治疗对原发性肝癌的穿刺准确,消融彻底,安全性较高.
Objective To evaluate the value of CT-guided self-made positioning puncture device in radiofrequency ablation of liver tumors. Methods A total of 78 tumor foci from 64 patients with primary hepatocellular carcinoma treated with radiofrequency ablation from January 2010 to November 2014 were analyzed. Among them, 13 tumor diameters were 3.5-5.0 cm and 65 〈3.5 cm. The location and puncture of tumor lesion were performed by CT-guided positioning device, and the effect of puncture and lesion was evaluated by using tumor precise radiotherapy planning system. Radiofrequency ablation of tumor lesion was performed by tumor radiofrequency treatment system. Results The puncture error of all tumors in the space was 1-4 mm, the average puncture error was 2.9 mm, the complete ablation rate of tumor lesions was 93.59%（73/78）, and there was no serious complication in the course of treatment. After treatment, the alpha-fetoprotein and liver function were significantly improved, and the differences were statistically significant （both P〈0.05）. At 1 month after surgery, CT found that no tumor and ablation was enhanced, at 3 months after surgery, CT showed that the arterial phase of all the tumor lesions did not strengthen, all of them were low-density lesions, no ablation recurred. The recurrence rates of 1, 2, 3, and 4 years after treatment were 17.9 %, 29.9 %, 45.9 % and 55.0 %. Conclusion CT-guided radiofrequency ablation with self-made puncture device is effective in the diagnosis of primary liver cancer, ablation is complete and safe.
作者
姜金杰
杨福奎
Jiang Jinjie Yang Fukui(Department of Medical Imaging, Liaocheng City Second People＇s Hospital, Liaocheng 252600, Chin)
出处
《肿瘤研究与临床》
CAS
2017年第8期536-539,共4页
Cancer Research and Clinic
基金
山东省聊城市科学技术项目（2014-45）
关键词
肝肿瘤
消融技术
体层摄影术
X线计算机
自制定位穿刺器械
Ablation techniques
Liver neoplasms
Tomography, X-ray computed
Homemade needle positioning device
