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提升肝细胞癌射频消融疗效的技术性措施:外科视角 被引量:18

Technical measures to promote the efficacy of radiofrequency ablation for hepatocellular carcinoma: from the surgeon's per-spective
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摘要 近十多年来,射频消融(RFA)治疗肝细胞癌(HCC)的疗效不断提升,已成为早期HCC常用的治愈性手段。但是RFA在我国的开展尚不普遍,疗效也有待提高。本文从外科视角,对提升HCCRFA疗效的技术性措施进行了较系统的阐述,包括明确癌灶部位和范围、把握适应证和禁忌证、科学应用预治疗、合理选择RFA路径和经皮穿刺路径的引导方式、选择合适的射频电极、充分镇痛、保证充分的消融边界、优化消融策略、积极预防和诊治并发症、准确判定完全消融、规范随访、重复应用RFA治疗局部肿瘤进展和肝内复发病灶共13项,旨在为在我国进一步推广该技术提供规范和参考。 Radiofrequency ablation (RFA) has been recognized as a curative therapeutic modality for hepatocellu- lar carcinoma (HCC) for its increasing efficacy in the recent more than ten years. However, RFA has not been generally carried out in our country and the efficacy still waits for im- provement. This paper presents a systemic discussion on the technical measures to promote the efficacy of RFA for HCC from the surgeonrs perspective, aiming to provide technical standard and reference for the further popularization and ap- plication of RFA in China. The 13 measures include clarifi cation of the tumor location and extent, following the indica- tions and contraindications of RFA, scientific application of pretreatments, selection of the best approach of RFA and of the reasonble guiding method for pereutaneous RFA, selec-tion of suitable RFA probe, adequate analgesia, sufficient ablative margin to guarantee pathological complete ablation, optimization of ablaiton strategy, active prevention, diagnosis and treatment of complications, correct evaluation of complete ablation, standadized follow-up and selection of RFA to treat the local tumor progression and intrahepatic occurrence.
作者 孙文兵 丁雪梅 高君 柯山 王劭宏 孔健 SUN Wen-bing, DING Xue-mei, GAO Jun, KE Shan, WANG Shao-hong, KONG Jian. Department of Hepatobiliary Surgery, West Campus, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Bei- jing 100043, P. R. China
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2011年第7期534-538,共5页 Chinese Journal of Hepatobiliary Surgery
基金 国家自然科学基金资助项目(30872490) 北京市卫生系统高层次卫生技术人才培养项目(2009-311) 吴阶平医学科研基金资助项目(320.6750.07131)
关键词 肝细胞 射频消融 疗效 技术 视角 外科 Carcinoma, hepatocellular Radiofre- quency ablation Efficacy Technique Perspective,surgical
作者简介 通信作者:孙文兵,电子信箱:wb.sun@yahoo.corn.cn
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参考文献32

  • 1Burak KW,Kneteman NM.An evidence-based multidiscipli-nary approach to the management of hepatocellular carcinoma (HCC):the alberta HCC algorithm[J].Can J Gastroenterol,2010,24:643-650. 被引量:1
  • 2Lencioni R.Loco-regional treatment of hepatocellular carcino-ma[J].Hepatology,2010,52:762-773. 被引量:1
  • 3Jarnagin WR.Management of small hepatocellular carcinoma:a review of transplantation,resection,and ablation[J].Ann Surg Oncol,2010,17:1226-1233. 被引量:1
  • 4Lupo L,Panzera P,Giannelli G,et al.Single hepatocellular carcinoma ranging from 3 to 5 cm:radiofrequency ablation or resection[J]? HPB (Oxford),2007,9:429-434. 被引量:1
  • 5Sun WB,Ding XM,Ke S,et al.Repeated radiofrequency ablation as both salvage solution and curative treatment for spon-taneous rupture of giant medial lobe hepatocellular carcinoma[J].Chin Med J,2009,122:2067-2070. 被引量:1
  • 6柯山,丁雪梅,高君,孙文兵.以射频消融为主要手段救治巨大肝癌自发性破裂出血[J].中华外科杂志,2010,48(5):393-395. 被引量:14
  • 7孙文兵.重视病理性完全消融提高肝癌射频消融疗效[J].中华肝胆外科杂志,2011,17(3):182-185. 被引量:20
  • 8Crocetti L,de Baere T,Lencioni R.Quality improvement guidelines for radiofrequency ablation of liver tumours[J].Cardiovasc Intervent Radiol,2010,33:11-17. 被引量:1
  • 9中国抗癌协会肝癌专业委员会.中华医学会肝病学分会肝癌学组,中国抗癌协会临床肿瘤学协作专业委员会,原发性肝癌规范化诊治的专家共识.肝脏,2009,:14-245,237. 被引量:1
  • 10Thanos L,Mylona S,Galani P,et al.Overcoming the heat-sink phenomenon:successful radiofrequency thermal ablation of liver tumors in contact with blood vessels[J],Diagn Interv Radiol,2008,14:51-56. 被引量:1

二级参考文献68

  • 1刘臻玉,区金锐.肝癌患者肝内微小静脉浸润的预后及临床意义[J].中华普通外科杂志,2006,21(6):415-418. 被引量:12
  • 2Manikam J, Mahadeva S, Goh KL, et al. Percutaneous, non- operative radiofrequency ablation for haemostasis of ruptured hepatocellular carcinoma. Hepatogastroenterology, 2009,56 : 227- 230. 被引量:1
  • 3Ng KK, Lam CM, Poon RT, et al. Radiofrequency ablation as a salvage procedure for ruptured hepatocellular carcinoma. Hepatogastroenterology, 2003,50 : 1641 - 1643. 被引量:1
  • 4Fuchizaki U, Miyamori H, Kitagawa S, et al. Radiofrequency ablation for life-threatening ruptured hepatocellular carcinoma. J Hepatol,2004 ,40 :354-355. 被引量:1
  • 5Kobayashi M, Ikeda K, Hosaka T, et al. Successful control of ruptured hepatocellular carcinoma with radiofrequency ablation. J Gastroenterol,2004,39 : 192-193. 被引量:1
  • 6Gravante G, Sconocchia G, Ong SL, et al. Immunoregulatory effects of liver ablation therapies for the treatment of primary and metastatic liver malignancies. Liver Int,2009,29:18-24. 被引量:1
  • 7Zerbini A, Pilli M, Penna A, et al. Radiofrequency thermal ablation of hepatocellular carcinoma liver nodules can activate and enhance tumor-specific T-cell responses. Cancer Res ,2006,66 : 1139-1146. 被引量:1
  • 8Lai EC, Lau WY. Spontaneous rupture of hepatoeellular carcinoma: a systematic review. Arch Surg,2006,141:191-198. 被引量:1
  • 9Tan FL,Tan YM ,Chung AY,et al. Factors affecting early mortality in spontaneous rupture of hepatocellular carcinoma. ANZ J Surg, 2006,76:448-452. 被引量:1
  • 10Liu CL,Fan ST,Lo CM,et al. Management of spontaneous rupture of hepatoeellular carcinoma: single-center experience. J Clin Oncol,2001,19 :3725-3732. 被引量:1

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