姚健楠, 刘福全, 岳振东, 赵洪伟, 王磊, 范振华, 赵孟菲, 李志伟, 李捍卫. 射频消融治疗原发性肝癌围手术期安全性分析[J]. 中国肿瘤临床, 2012, 39(7): 404-407. DOI: 10.3969/j.issn.1000-8179.2012.07.011
引用本文: 姚健楠, 刘福全, 岳振东, 赵洪伟, 王磊, 范振华, 赵孟菲, 李志伟, 李捍卫. 射频消融治疗原发性肝癌围手术期安全性分析[J]. 中国肿瘤临床, 2012, 39(7): 404-407. DOI: 10.3969/j.issn.1000-8179.2012.07.011
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Jiannan YAO, Fuquan LIU, Zhendong YUE, Hongwei ZHAO, Lei WANG, Zhenhua FAN, Mengfei ZHAO, Zhiwei LI, Hanwei LI. Safety Evaluation of Radiofrequency Ablation for Hepatocellular Carcinoma: An Analysis of 729 Cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(7): 404-407. DOI: 10.3969/j.issn.1000-8179.2012.07.011
Citation: Jiannan YAO, Fuquan LIU, Zhendong YUE, Hongwei ZHAO, Lei WANG, Zhenhua FAN, Mengfei ZHAO, Zhiwei LI, Hanwei LI. Safety Evaluation of Radiofrequency Ablation for Hepatocellular Carcinoma: An Analysis of 729 Cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(7): 404-407. DOI: 10.3969/j.issn.1000-8179.2012.07.011
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射频消融治疗原发性肝癌围手术期安全性分析

Safety Evaluation of Radiofrequency Ablation for Hepatocellular Carcinoma: An Analysis of 729 Cases

    摘要
  • 摘要:
      目的  讨论射频消融术治疗原发性肝癌(HCC)的安全性及其并发症的防治。
      方法  对2001年1月至2011年6月531例原发性肝癌患者共653个病灶, 729例次行射频消融治疗。
      结果  CT引导下、数字减影血管造影机(digital subtraction angiogra-phy, DSA)引导下及DSA与Dvna-CT联合引导下射频消融术分别为165例次、351例次及213例次; 本组病例总死亡率0.3%(2/729), 因消化道大出血及肝功能衰竭死亡各1例; 总并发症发生率为4.1%(30/729), 其中CT引导下并发症发生率为10.9%(18/165), DSA引导下及DSA与Dvna-CT联合引导下并发症发生率为2.1%(12/564), 两者比较有显著性差异(χ2=24.95, P<0.05)。并发症包括: 腹腔出血0.5%(4/729)、胆管损伤0.1%(1/729)、肝功能衰竭0.1%(1/729)、肺部并发症(胸腔出血、肺部感染)0.3%(2/729)、气胸1.8%(13/729)、皮肤灼伤0.4%(3/729)、门静脉损伤0.4%(3/729)、肝脓肿0.1%(1/729)、消化道出血0.3%(2/729), 无其他严重合并症发生。
      结论  射频消融术治疗原发性肝癌有发生合并症的风险。根据病灶内碘油沉积情况、病灶与重要器官或组织的关系选择不同的引导方式, 会降低发生合并症的风险.

     

    Abstract:
      Objective  This study aims to discuss the safety of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) and the mechanisms to prevent its complications.
      Methods  A retrospective study was conducted on the clinical data of 729 RFA treatments to 653 HCC nodules in 531 patients during a 10-year period between January 2001 and June 2011.
      Results  The number of treatments using computed tomography (CT)-guided RFA, digital subtraction angiography (DSA)-guided RFA, and DSA combined with Dyna-CT-guided RFA was 165, 351, and 213, respectively. Two among 729 patients (0.3%) died, which was attributed to gastro- intestinal hemorrhage and liver failure, respectively. Among the patients, complications occurred in 4.1% (30/729): intra-abdominal hemorrhage in 0.5% (4/729), bile duct injury in 0.1% (1/729), liver failure in 0.1% (1/729), pulmonary complications (hemothorax and pulmonary infection) in 0.3% (2/729), pneumothorax in 1.8% (13/729), skin bum in 0.4% (3/729), portal vein injury in 0.4% (3/ 729), liver abscess in 0.1% (1/729), and gastrointestinal hemorrhage in 0.3% (2/729), with no other serious complications. The rate of complications for the CT-guided RFA was 10.9% (18/165), whereas that for the DSA-guided and DSA combined with Dyna-CT-guided RFA was 2.1% (12/564). The difference between the two groups was statistically significant (χ2 = 24.95, P < 0.05).
      Conclusion  Com- plications may occur after RFA, which can be reduced by cautious choice of suitable cases judging from the sedimentation of lipiodol and the relationship between the lesions and important organs or tissues.

     

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