摘要：
目的 评估超声引导下射频消融(radiofrequency ablation,RFA)肝移植状态下肝癌的临床应用价值.方法 回顾性分析2009年7月至2012年6月在我院行超声引导下肝癌射频消融治疗的11例肝移植术后患者的临床资料,综合评价疗效,分析病灶的完全消融率,局部复发率,肝内复发率.以术后1月MRI、CECT复查病灶无异常强化,或超声造影检查病灶完全无强化为局部完全消融的标准,复发病灶距原射频消融病灶＜0.5 cm为局部复发,＞0.5 cm为肝内复发.结果 11例患者(均为男性,年龄37～64岁,平均49岁)共行12次肝脏RFA治疗,共消融病灶数19个,术后随访1～11个月.术后局部完全消融率100％ (19/19),局部复发率0,肝内复发率66.7％ (8/12).结论 超声引导下射频消融治疗肝移植术后肝癌的局部灭活率高,并发症较少,安全性较高,可作为肝移植术后肝癌的一项局部治疗手段.但由于免疫抑制剂的应用等原因,肝内及肝外肿瘤的复发率较高,不能有效延缓肿瘤进展,需要联合其他治疗手段.%Objective To evaluate the clinical value of untrasound guided radiofrequency ablation(RFA) for patients who have had a liver transplantation.Methods Retrospectively analyzed the clinical data of eleven patients who were treated with RFA after a liver transplantation between July 2009 and June 2012.Based on these materials,we evaluated its effectiveness and the local complete ablation rate,local recurrence rate and distant recurrence rate.The local complete ablation were based on no strengthen area in post-RFA imaging examination one month later.If one nodule recurred within 0.5 cm from the ablated nodule,define it as a local recurrence,on the contrary,name it a distant recurrence.Results Nineteen lesions were ablated in twelve times of RFA for 11 patients(all men,37 to 64 years old,average of 49 years old),follow-up of 1～11 months.The complete ablation rate、local recurrence rate and distant recurrence rate were 100％ (14/14),0 and 66.7％(8/12).Conclusions Because of its high local inactivation rate、low ratc of complication and high safety level,ultrasound-guided radiofrequency ablation can be used as a local therapy for hepatocellular carcinoma after liver transplantation.Whereas,because of the usage of immunosuppression,there are high incidence of neoplasia.So the RFA cannot control the progression of tumor without other medical treatments effectively.
