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目的探讨冷循环射频消融治疗实性肿瘤的疗效、适应证和并发症。方法对102例肿瘤患者共157个实质性肿块行冷循环射频治疗。肿块直径1~20cm,平均4·03cm。结果肿块直径小于5cm的完全消融(complete ablation,CA)率为83·5%(91/109),大于5cm为35·4%(17/48)。射频后多数肺癌患者症状明显改善。胰腺癌组中40%(4/10)的患者术后疼痛消失或减轻。经皮穿刺组无中转手术,无皮肤烧伤,无气胸。肝脏射频术中有13·4%(11/82)出现疼痛和6·1%(5/82)出现恶心;术后9·7%(8/82)出现黄疸;23·2%(19/82)出现发热;3·7%(3/82)出现胸腔积液;1·2%(1/82)出现胆漏。肺癌射频术中14·3%(1/7)出现疼痛,术后14·3%(1/7)出现皮下气肿。胰腺射频20%(2/10)并发胰漏;70%(7/10)出现血淀粉酶升高;20%(2/10)出现消化道出血。结论冷循环射频消融治疗实质肿瘤有效、适应证广且安全,但胰腺射频应慎重进行。
Objective To investigate the efficacy, indications and complications of cold-cycle radiofrequency ablation in the treatment of solid tumors. Methods A total of 157 substantive masses of 102 patients with tumor were treated by cold-cycle radiofrequency. Mass diameter of 1 ~ 20cm, an average of 4.03cm. Results The rate of complete ablation (CA) was 83.5% (91/109) when the diameter of the tumor was less than 5 cm and 35.4% (17/48) when the diameter was less than 5 cm. After the majority of lung cancer patients with radio frequency symptoms improved significantly. Forty percent (4/10) of the patients in the pancreatic cancer group had no or reduced postoperative pain. Percutaneous puncture group without transit surgery, no skin burns, no pneumothorax. Nausea occurred in 13.4% (11/82) of the liver radiofrequency and nausea in 6.1% (5/82) of the patients; Jaundice occurred in 9.7% (8/82) of the patients after radiotherapy; 23.2% 82) developed fever; pleural effusion was found in 3.7% (3/82); bile leakage occurred in 1.2% (1/82). Pain was found in 14.3% (1/7) of the radiofrequency radiofrequency lung cancer patients and subcutaneous emphysema occurred in 14.3% (1/7) of the patients after radiotherapy. Pancreatic radiofrequency 20% (2/10) concurrent pancreatic leakage; 70% (7/10) of the blood amylase increased; 20% (2/10) of gastrointestinal bleeding. Conclusion Cold cycle radiofrequency ablation is effective in treating solid tumors, with a wide range of indications and safety, but the pancreatic radiofrequency should be carefully performed.