目的 总结第三军医大学西南医院肝胆外科研究所临床使用多电极转换系统射频消融治疗肝脏肿瘤的临床经验,以评估其有效性和安全性.方法 2014年12月至2015年12月第三军医大学西南医院肝胆外科研究所在178次多电极转换系统射频消融治疗304个肿瘤,平均直径4.72 cm(2.2~10.4 cm);入组病人176例(134例男性和42例女性),平均年龄52.95岁(22~83岁),术后24 h或者48 h行肝脏超声造影或者肝脏增强CT检查,以评估是否完全消融和是否有并发症的发生.结果 304个肝脏肿瘤,多电极转换系统完全消融率为98.68%(300/304),一次性完全消融率为98.02%(298/304),176例肝脏肿瘤病人多电极转换系统总消融时间为2275 min,平均消融时间为(13.04±5.39)min,比单电极射频消融时间节约56.24%;入组的176例病人无住院死亡情况,并发症发生率为2.35%.统计学单因素分析证实消融区最大直径与肿瘤类型、肿瘤数目、电极数量、肿瘤直径、起始功率和治疗时间均有关,与肿瘤直径和肿瘤数目呈正相关.结论 多电极转换系统射频消融治疗肝脏肿瘤是一项安全、有效的操作方法,提高了射频消融治疗肝脏肿瘤一次性消融率,相对较短的射频消融时间降低了麻醉风险和手术风险.%Objective To assess the effectiveness and safety of a novel radiofrequency ablation (RFA)with a multiple-electrode switching system for the treatment of liver tumors.Methods We performed a total of 178 RFAs with a multiple-electrode switching system on 176 patients from Dec. 2014 to Dec.2015.There were a total of 304 tumors treated with an average diameter of 4.72 ± 1.7 cm (range,2.2±10.4 cm).There were 134 male patients and 42 female patients with a mean age of 52.95±11.87 years old (range,22-83).Ultrasonography or contrast-enhanced CT of the liver was performed 48 h after the surgery to determine whether the ablation was complete and whether compli-cations occurred.Results For the treatment of 304 liver tumors,the complete ablation rate of multi-e-lectrode switching system was 98.68% (300/304),and the complete ablation rate with one procedure was 98.02% (298/304).The total ablation time was 2275 min,and the mean ablation time per pro-cedure was 13.04±5.39 min,and there was a 56.24% reduction relative to that of single-electrode RFA.No hospital deaths occurred in any of the enrolled 176 patients.The complication rate was 2.35%.Conclusions Multiple-electrode switching RFA is a safe and effective method for treating liver tumors.It was here found to improve the complete ablation rate with one procedure in RFA treatment of liver tumors and to shorten the RFA time,which reduces surgical risks.
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