CT引导下经肺或肋膈角射频消融治疗肝顶部肿瘤

发布时间：2018-05-22 20:00

本文选题：射频消融 + 肝肿瘤　；参考：《中国介入影像与治疗学》2015年05期

【摘要】：目的探讨CT引导下、经肋膈角或肺组织对肝顶部肿瘤进行射频消融治疗的安全性及可行性。方法对45例肝顶部肿瘤患者采用CT引导下经肋膈角或肺组织入路行射频消融治疗。记录过肺组织或肋膈角电极针数目及肺组织内电极针长度。分析围手术期并发症及临床疗效。结果 45例肝顶部肿瘤患者,原发性肝癌34例,转移癌11例。全身麻醉34例,局部麻醉11例。病变最大径0.91~6.67cm,中位数1.83cm。肺组织内电极长度0~59.42mm,中位数9.90mm。单针过肺13例,2针同时过肺13例,3针同时过肺3例,单独1支过肋膈角8例,1支过肋膈角同时1支过肺组织7例,1支过肋膈角同时2支过肺组织1例。无症状少量气胸11例(11/45,24.44%)。肺组织穿刺针道少量出血6例,右肩部疼痛9例,1周左右症状消失。随访3~14个月,局部复发7例(7/45,15.56%)。结论经肋膈角或肺穿刺射频消融治疗肝脏恶性肿瘤安全可行,尤其对于射频消融治疗时常规路径无法到位的肝顶部肿瘤,可采用此方法。
[Abstract]:Objective to evaluate the safety and feasibility of radiofrequency ablation (RFA) in the treatment of hepatic parietal tumors under CT guidance. Methods 45 patients with parihepatic tumors were treated by radiofrequency ablation under CT guidance. The number of needle electrodes and the length of electrode needles in lung tissue were recorded. Analysis of perioperative complications and clinical efficacy. Results there were 45 patients with parihepatic tumor, 34 with primary liver cancer and 11 with metastatic carcinoma. There were 34 cases of general anesthesia and 11 cases of local anesthesia. The maximum diameter of lesion was 0.91 卤6.67 cm and the median was 1.83 cm. The electrode length in lung tissue was 59.42 mm with a median of 9.90 mm. There were 13 cases of single needle passing through the lung and 13 cases of lung passing 3 needles and 3 cases of lung passing, 8 cases of single branch passing through the costal phrenic angle 8 cases of one branch passing through the costal phrenic angle and 7 cases of the lung tissue passing 1 branch through the costal diaphragm angle and 2 branches through the lung tissue. There were 11 cases of asymptomatic pneumothorax (11 / 45) and 24. 44% of pneumothorax. There were 6 cases of hemorrhage in the needle passage of lung tissue and 9 cases of pain in the right shoulder. Follow-up for 3 ~ 14 months showed 7 cases of local recurrence. Conclusion it is safe and feasible to treat hepatic malignant tumor by radiofrequency ablation via costal angle or lung puncture, especially for the tumor at the top of the liver where the routine pathway is not in place during radiofrequency ablation.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;
【分类号】：R735.7;R730.44

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