[1]张智坚,吴孟超,陈汉.射频消融肝脏恶性肿瘤并发症的防治[J].中国微创外科杂志,2005,05(2):113-115.
　Zhang Zhijian,WuMengchao,Chen Han..Prevention and treatment for complications of radiofrequency ablation for hepatic malignancy[J].Chinese Journal of Minimally Invasive Surgery,2005,05(2):113-115.
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射频消融肝脏恶性肿瘤并发症的防治()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
05
期数:
2005年2期
页码:
113-115
栏目:
出版日期:
2005-02-28

文章信息/Info

Title:
Prevention and treatment for complications of radiofrequency ablation for hepatic malignancy
作者:
张智坚; 吴孟超; 陈汉
第二军医大学东方肝胆外科医院,上海,200438
Author(s):
Zhang Zhijian;  WuMengchao; Chen Han.
Eastern Hepatobiliary Surgery Hospital of Second Military Medical University, Shanghai 200438, China
关键词:
肝肿瘤;  射频;  并发症
Keywords:
Hepatic tumor; 　Radiofrequency; 　Complication
分类号:
R735.705.4
文献标志码:
A
摘要:
目的探讨肝恶性肿瘤射频消融术中、术后并发症的预防和治疗. 方法 1999年10月～2003年3月,353例经病理和临床证实为原发性肝癌、继发性肝恶性肿瘤者进行452例次射频消融治疗,其中经皮肝穿刺治疗344例,开腹术中进行9例.未手术原发性肝癌198例,肝癌术后复发81例,继发性肝恶性肿瘤74例.定期随访,了解与手术相关的近、远期并发症. 结果发生并发症12例,其中电极皮肤灼伤2例,气胸1例,右胸腔积液1例,腔静脉血栓1例,右肝管损伤狭窄1例,胃损伤外瘘1例,肝左外叶胆管外瘘1例,单纯肝脓肿1例,肝脓肿致升结肠外瘘1例,肝脓肿致十二指肠、肝、右胸腔内瘘1例,内出血1例.并发症发生率2.65%(12/452),并发症相关死亡率8.33%(1/12). 结论射频消融是一种微创治疗,但对于肝门区、肝表面和与空腔脏器贴近的部位,尤其是有腹腔手术史且空腔脏器与肝脏相粘连者,经皮肝穿刺射频治疗有一定危险性.术前适应证选择恰当,术中仔细操作,术后加强监护、预防感染、止血等,一些并发症是可以有效预防和治疗的.
Abstract:
Objective　To study the prevention and treatment of intra- or post- operative complications of radiofrequency ablation (RFA) for hepatic malignancy.　M ethods　A series of 353 patients with primary hepatic carcinoma or secondary hepatic malignancy verified by pathological examinations and clinicalmanifestations underwent 452 times ofRFA between October 1999 and March 2003, including 344 cases of percutaneous RFA and 9 cases ofRFA during open surgery. There were 198 cases of primary hepatic carcinoma previously unoperated, 81 cases of recurrent hepatic carcinoma after surgery, and 74 cases of secondary hepatic malignancy. All the patientswere followed up to make out short- or long-term surgical complications.　Results　Complications happened in 12 cases: skin burn by the electrode (2 cases), pneumothorax (1 case), right hydrothorax (1 case), vena cava thrombus (1 case), rightbile duct injury and stricture (1 case), gastric external fistula (1 case), bile leakage in the left lateral lobe of the liver (1 case), hepatic abscess (1 case), external fistula of the ascending colon resulted from hepatic abscess (1 case), internal fistula of the duodenum, liver and right thorax resulted from hepatic abscess (1 case), and intra-abdominal hemorrhage (1 case). The incidence of complication was 2·65% (12/452) and the complication- related mortality was 8·33% (1/12).　 Conclusions　RFA is a kind ofminimally invasive procedure. But RFA especially percutaneous RFA may involve some risks for patientswith the tumor located at the porta hepatic or the surface of the liver, or adhered to hollow organs, especially thosewho had a history of abdominaloperation and adhesions ofhollow viscera to the liver. Some complications can be prevented and effectively treated in the event of proper selection of patients, careful performance during the surgery, intensive postoperative care, effective hemostasia and efficient infection prevention.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：上海市科学技术发展基金资助项目(014119043)
更新日期/Last Update: 2014-03-11