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“针”功夫!我院运用射频消融治疗小肝癌疗效显著

没有手术刀,仅凭1根长长的“针”就顺利完成了肝癌治疗!近日,市四院肝脏肿瘤科再次运用射频消融术成功治疗了1例小肝癌患者,术后患者恢复良好。

患者老丁,有乙肝肝硬化病史多年,近期磁共振检查时发现肝脏新发一大小约0.8cm的肿块AFP(诊断肝癌的重要指标)仅轻度升高,是肿瘤还是肝硬化结节?患者焦躁不安,因为没有人能给出一个准确的答案。“就算是癌症,我也坚决不开刀!”老丁坚定说。

“患者肝硬化程度严重,即便查出肝癌,也不能耐受手术切除治疗;而高昂的肝移植费用,患者也承受不了。”入院后,肝脏肿瘤科主任吕春对患者病情进行仔细分析并拟定治疗方案,“患者病灶小,首先在CT引导下行肝组织穿刺病理活检,如果确诊为肝癌,选择经皮穿刺射频消融治疗。

入院第二天,抽血检查结果出来了,没有穿刺禁忌症,吕主任就为老丁安排了穿刺检查。由于患者病0.8cm,穿刺组织活检有难度,吕主任凭借精湛的手法与极强的责任心,用肝穿针在病变中心及周围多点取材,快速病理结果提示为高分化肝细胞肝癌,患者肝癌诊断明确。治疗按照原方案进行!于是吕主任手中的“针”由肝脏穿刺针换成了射频消融针,每次进针都经过认真计算和评估,每个进针角度与深度都经过准确测量,目的就是为了给患者一个最佳的治疗效果。手术总耗时1小时45分钟,患者除了感觉穿刺部位轻微疼痛外,无其他不适,术后第二天就下床自由活动了。

吕春主任介绍,射频消融基本原理是应用冷循环射频针穿刺至肿瘤组织内,释放射频电流导致肿瘤组织产生热能,细胞内水分蒸发、蛋白质变性达到凝固性坏死,使一定范围的病灶毁损而达到治疗目的。但每种手术方式都有其适应症,严格掌握手术适应症是治疗成功与否的关键。肝癌射频消融的适应症包括:1.肝硬化严重,不能耐受开腹切除手术;2.肝脏肿瘤位置不佳,手术切除难度大;3.合并心肺功能不全或其它脏器严重并发症,无法耐受常规手术;4.肝癌术后复发,不宜或不愿接受再次手术患者;5.肝脏多发性转移性恶性肿瘤,肿瘤≤3个;6.单发癌灶,最大直径≤5cm;或者肝内多发肿瘤,单个肿瘤最大直径≤3cm

吕春主任表示,射频消融治疗对于直径3cm以下、病灶数<3个、无门静脉癌栓或肝外转移的肝癌,肿瘤完全坏死率可达90%以上,其疗效接近手术切除,而对患者的损伤远低于手术治疗,它不仅可以阻断恶性肿瘤的供血,而且可以防止恶性肿瘤细胞随血液远处转移,目前与常规手术切除、超选择性肝动脉化疗栓塞术并称为三大高效治疗肝癌的方法。

为患者制定最佳的个体化治疗方案,在治疗肝脏肿瘤的同时尽量减小对肝脏的破坏,是市四院肝脏肿瘤科的治疗宗旨。2011年成立以来,先后开展了多项肝癌微创治疗手段,为肝癌患者带来生的希望。  

                                                                            (沈兰超 张丽娟)

 

发布时间:2018/10/12 10:27:37 点击率:56 [返回上一页]
 
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