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中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2014, Vol. 02 ›› Issue (03) : 45 -48. doi: 10.3877/cma.j.issn.2095-5782.2014.03.013

所属专题： 文献；

非血管介入

CT引导下经皮穿刺射频消融补救性治疗晚期肾癌
顾克峰1, 潘峰1, 韩庆涛1, 高淑萍1, 李燕1, 王科学1, 于海鹏2,†()   
  1. 1. 250200　章丘市人民医院介入科
    2. 300060　天津医科大学肿瘤医院介入治疗科，国家临床医学研究中心，天津市肿瘤防治重点实验室
  • 收稿日期:2013-07-08 出版日期:2014-08-01
  • 通信作者: 于海鹏

CT-guided percutaneous radiofrequency in remedial treatment of advanced renal cell carcinoma

Kefeng Gu1, Feng Pan1, Qingtao Han1, Shuping Gao1, Yan Li1, Kexue Wang1, Haipeng Yu2,†()   

  1. 1. Department of Interventional Radiology, the People’s Hospital of Zhangqiu, Zhnagqiu 250200, China
  • Received:2013-07-08 Published:2014-08-01
  • Corresponding author: Haipeng Yu
  • About author:
    Corresponding author: Yu Haipeng, Email:
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顾克峰, 潘峰, 韩庆涛, 高淑萍, 李燕, 王科学, 于海鹏. CT引导下经皮穿刺射频消融补救性治疗晚期肾癌[J]. 中华介入放射学电子杂志, 2014, 02(03): 45-48.

Kefeng Gu, Feng Pan, Qingtao Han, Shuping Gao, Yan Li, Kexue Wang, Haipeng Yu. CT-guided percutaneous radiofrequency in remedial treatment of advanced renal cell carcinoma[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2014, 02(03): 45-48.

目的

探讨射频消融治疗肾细胞癌（RCC）的有效性及安全性。

方法

收集56例不适宜外科切除治疗的RCC患者。肿瘤直径为2.6～8.6 cm，平均（5.6±1.2）cm。CT引导下行经皮穿刺射频消融术。随访评估临床效果、肾功能和并发症状况。

结果

本组56例患者中，病灶直径<4 cm的35患者射频治疗后1、3、6个月复查时均未见病灶强化，病灶直径>4 cm的21例，在术后3个月复查时13例出现治疗边缘强化，活检证实为复发病灶，再次行射频消融治疗。截止随访时间内，50例存活，6例死于非肿瘤原因。射频治疗前后肾功能变化差异无统计学意义。并发症轻微，无肾脏出血、感染、肾盂损伤等严重并发症。

结论

经皮穿刺射频消融治疗可使无外科手术机会的RCC患者生存获益，并能很好的保护患者肾功能，同时并发症轻微，可作为一种重要的治疗手段。

关键词: 肾肿瘤, 导管消融, 疗效
Objective

To evaluate clinical efficacy and safety of percutaneous radiofrequency ablation (RFA) in treatment of renal cell carcinoma (RCC).

Methods

A total of 56 patients with RCC who were not suitable for surgical resection were analyzed. The longest diameter of the lesions ranged from 2.6 to 8.6 cm with a mean of (5.6±1.2)cm. The oncological outcomes, renal function and complications were observed.

Results

The CT images showed no enhancement of the lesion when evaluated 1, 3, 6 months after RFA for tumors diameter less than 4 cm in 35 cases. For 21 cases with tumors more than 4 cm, 13 cases required a second session of RFA because of recurrence. During follow-up period, 50 patients survived, 6 patients died of non tumor causes. There was no difference between before and after treatment in renal function. Most common complications associated with treatment were minor. No hemorrhage at the probe insertion site, infection and pelvis injury occurred.

Conclusions

Midterm follow-up shows that percutaneous renal RFA is an effective and safe alternative technique for patients with RCC whose condition does not allow surgery and that renal function is preserved and complications is mild.

Key words: Kidney neoplasms, Catheter ablation, Curative effect
表1 56例患者RFA治疗前后肾功能变化
时间 尿素 肌酐
（±SD,mmol/L） t值 P值 （±SD,mmol/L） t值 P值
术前 5.53±1.16 ? ? 65.50±9.62 ? ?
术后1周 5.45±0.98 0.358 0.726 66.19±9.40 1.439 0.174
术后1个月 5.62±0.83 0.710 0.490 66.49±8.78 0.905 0.382
术后3个月 5.49±0.93 0.427 0.676 66.26±8.20 1.996 0.069
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