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目的探讨手术不能切除肝癌行深部冷冻治疗的效果及其并发症的防治。方法从1988年5月至2003年12月应用APCA1-3型冷冻治疗机冷冻治疗不能切除的肝癌134例,癌块直径平均为8.7cm,其中原发性肝癌122例。总结冷冻治疗效果并比较三个时期冷冻治疗肝癌后并发症及其死亡率:1988年至1992年36例,1993年至1997年32例,1998年至2003年66例。结果病理检查显示冷冻区肝组织及肝肿瘤为不可逆性坏死。其1、3、5年生存率分别为76.4%、39.8%、27.4%,围手术期死亡率为3%(4/134)。术后腹腔内出血及肝功能衰竭,两项并发症在三个时段的发生率及手术期死亡率依次递减,分别为22.1%、11.7%、7.5%;5.5%、3.1%、1.5%。结论深部冷冻治疗手术不能切除的肝癌是一个有效的方法。改进冷冻设施及手术技术措施,可以减少并发症的发生及围手术期死亡。
Objective To investigate the effect of deep cryotherapy in the treatment of unresectable liver cancer and the prevention and treatment of its complications. Methods From May 1988 to December 2003, 134 cases of unresectable hepatocellular carcinoma (HCC) were treated with APCA1-3 cryogenic treatment machine. The average diameter of tumor mass was 8.7 cm, of which 122 were primary hepatocellular carcinoma. To summarize the effects of cryotherapy and to compare the complications and mortality of hepatocellular carcinoma after three periods of cryotherapy: 36 cases from 1988 to 1992, 32 cases from 1993 to 1997 and 66 cases from 1998 to 2003. Results Pathological examination showed that the frozen tissue of liver and liver tumors were irreversible necrosis. The 1, 3, 5-year survival rates were 76.4%, 39.8% and 27.4% respectively, and the perioperative mortality rate was 3% (4/134). Postoperative intraperitoneal hemorrhage and liver failure, the two complications in three periods of incidence and mortality decreased sequentially, were 22.1%, 11.7%, 7.5%, 5.5%, 3.1%, 1.5%. Conclusion Deep cryotherapy for unresectable liver cancer is an effective method. Improve the freezing facilities and surgical techniques and measures to reduce the incidence of complications and perioperative deaths.