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目的 观察射频消融治疗肝肿瘤的疗效并探讨其评价方法。方法 采用射频消融治疗兔肝VX2肿瘤,观察肿瘤完全坏死率、病理改变、CT表现及动物生存时间。结果（1）ALT在射频消融（radio frequency ablation,RFA）治疗后第 1天明显升高 （124.7±27.1）U/L,4～7d降到治疗前的水平以下（46.8±13.1）U/L。（2）治疗后第2周,完全坏死的肿瘤CT示病灶范围稍扩大,其内密度不均,增强扫描显示病灶内无明显强化,但其边缘可出现环状强化带,活体观察见暗灰色的坏死组织被形状规则、呈环状生长的肉芽组织环绕;而RFA治疗后未完全坏死的肿瘤病灶CT平扫与完全坏死者类似,但增强扫描显示病灶内有不规则强化区域,活体观察显示坏死灶周围与正常肝脏之间增生的组织形状不规则,病理活检结果为肿瘤复发。（3）与对照组相比,治疗组平均生存时间明显延长,肺转移率及病死率也明显降低。结论RFA对肝肿瘤的治疗效果确切可靠,对肝功能的损伤小;RFA治疗后CT增强扫描与病灶的病理形态学表现有较好的一致性,是RFA治疗后观察肿瘤消融结果有价值的检查手段。
Objective To observe the curative effect of radiofrequency ablation on liver tumor and to discuss its evaluation method. Methods Radiofrequency catheter ablation was used to treat rabbit VX2 tumors. The complete tumor necrosis rate, pathological changes, CT findings and animal survival time were observed. Results (1) ALT was significantly increased (124.7 ± 27.1) U / L on the first day after radio frequency ablation (RFA) treatment and decreased to 46.8 ± 13.1 U / L after 4 ~ 7 days . (2) In the second week after treatment, the complete necrosis of the tumor showed a slightly enlarged lesion in the lesion with uneven density. The enhancement scan showed no significant enhancement in the lesion but a ring-like enhancement band appeared on the edge of the lesion. Of necrotic tissue surrounded by granulation tissue with regular shape and ring-shaped growth. CT scan of incompletely necrotic tumor lesions after RFA treatment was similar to that of complete necrosis, but enhanced scan revealed irregular enhancement areas in lesions and in vivo observation showed The tissue shape of hyperplasia around the necrotic lesion and normal liver is irregular, and the result of pathological biopsy is tumor recurrence. (3) Compared with the control group, the mean survival time of the treatment group was significantly prolonged, lung metastasis rate and mortality rate were also significantly reduced. Conclusion RFA has a reliable effect on the treatment of liver tumors and less damage to liver function. The enhancement of pathological features of CT scan after RFA is consistent with the pathological findings of RFA, which is valuable for observing tumor ablation results after RFA treatment means.