目的探讨肝癌深度冷冻治疗围手术期并发症。方法应用LCS-2000型深度冷冻治癌机治疗肝癌患者65例，男性60例，女性5例，年龄26～72岁，中位年龄54.8岁，癌灶直径小于5cm 16例，5～10cm 24例，大于10cm 25例。其中原发性肝癌54例，国际TNM分期Ⅱ期12例，Ⅲ期14例，Ⅳa期22例，Ⅳb期6例。乙肝表面抗原（HBsAg）阳性率94％（51／54），甲胎球蛋白（AFP）阳性率70％（38／54）。继发性肝癌11例，原发癌为结肠癌4例、直肠癌2例、胆囊癌2例、胰腺癌1例、乳腺癌1例、后腹膜平滑肌肉瘤1例。结果全组围手术期并发症13例16个，并发症发生率20％（13／65）。包括术后腹内出血3例、肝功能衰竭3例、上消化道出血6例、感染4例。结论肝癌深度冷冻治疗为部分不能手术切除的患者提供了有效的治疗手段，但应严格掌握手术适应证。%Objective To study the postocryosurgery complications in patients with liver tumors.Methods Cryogenic surgical LCS-2000 system was used for the tratment of 65 patients with primary and secondary liver cancers.There were 60 males and 5 females.The tumor was less than 5 cm in diameter in 16 cases,5～10cm in 24 cases and larger than 10cm in 25 cases.There were 54 patients with primary liver cancer,among them 12 cases on tumor TNM classification Ⅱ，14 on Ⅲ,22 on Ⅳa and 6 on Ⅳb.There were 11 patients with secondary liver cancer,the primary foci were found in gastrointestinal tract,breast and retroperitonium,respective.ResultsSixteen postotherapy complications developed in 13 patients.With an incidence of 20％(13/65),and the mortality of 3.1％(2/65).Complications that developed were as follows:intra-abdominal bleeding in 3 cases,hepatic failure in 3 cases,upper digestive tract bleeding in 6 cases,infection in 4 cases.Conclusion Liver cryosurgery is a relatively new form of treatment for unresectable liver cancer that involves in situ ablation of liver tumor by freezing with liquid nitrogen.A surgeon must adhere strictly to the indication of operation.
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