目的　评价CT透视引导经皮穿刺乙酸注射治疗 (PAI)第二肝门区恶性肿瘤的安全性和效果。方法　搜集西南医院 2 0 0 0年 5月至 2 0 0 3年 10月在实时CT透视导向下经皮穿刺乙酸注射治疗第二肝门区恶性肿瘤 17例 ,肝细胞癌 10例、转移性腺癌 7例 ,共 2 0个病灶。病灶直径 2～ 5cm。根据病灶大小每次注入 5 0 %～ 6 0 %乙酸 2～ 6ml不等 ,乙酸内加入 1ml对比剂混匀 ,以了解乙酸在肿块内的弥散程度和范围。注射后 1周影像检查 ,根据情况重复注射 1～ 2次。结果　在实时CT透视下均能准确穿刺到靶点 ,除 12例轻中度疼痛外无其它并发症。全部病例均经B超或CT随访 ,3个月时 ,其中瘤灶缩小 14个 (70 % ) ,肿瘤大小无变化 4个 (2 0 % ) ,肿瘤增大 2个 (10 % )。 17例随访 3月 ,全部生存 ;12例随访 1年 ,9例生存 ,5例失访 ;6例随访 2年 ,3例生存 ,3例失访。结论　CTF引导下经皮乙酸消融治疗第二肝门部恶性肿瘤是安全有效的 Objective To evaluate the safety and efficacy of CT fluoroscopy in the percutaneous parathyroidectomy (PAI) of the second hilar region malignant tumor. Methods From May 2000 to October 2003, 17 cases of second hilar malignant tumor, 10 cases of hepatocellular carcinoma and 10 cases of metastatic adenocarcinoma were treated by percutaneous acetic acid injection under the guidance of real-time CT fluoroscopy in Southwest Hospital from 2000 to October 2003. 7 cases, a total of 20 lesions. Lesion diameter 2 ~ 5cm. According to the size of the lesion each injection of 50% ~ 60% acetic acid 2 ~ 6ml range, acetic acid, add 1ml contrast agent mix to understand the degree of dispersion of acetic acid in the mass and extent. 1 week after injection imaging, according to the situation repeated injections 1 or 2 times. Results in real-time CT fluoroscopy can accurately puncture the target, in addition to 12 cases of mild to moderate pain without complications. All cases were followed up by B ultrasound or CT. At 3 months, the tumor size was reduced by 14 (70%), the tumor size was unchanged by 4 (20%) and the tumor size was increased by 2 (10%). Seventeen patients were followed up for 3 months and all survived. Twelve patients were followed up for 1 year, 9 survived and 5 lost their follow-up. Six patients were followed up for 2 years, 3 survived and 3 lost their follow-up. Conclusion CTF-guided percutaneous acetic acid ablation in the treatment of the second hilar malignant tumor is safe and effective