论文标题:集束高频电针热凝治疗装置的国产化实验研究与临床应用
The Experiment Research and Clinical Application of Domestic Cluster High Frequency Electrode Needles and Heating Coagulation Therapeutic Appliance
论文作者 姜立新
论文导师 吕国荣；李新丰,论文学位 硕士,论文专业 影像医学与核医学
论文单位 福建医科大学,点击次数 1,论文页数 46页File Size7583k
2003-04-01论文免费下载 http://paper.dic123.com/lunwen_106387262/ 超声检查,介入性,射频,肝癌,治疗
Ultrasonography;Interventional;Radiofrequency;Hepatic carcinoma;Therapy
[目的] 探讨集束高频电针热凝治疗装置的国产化问题，比较国内外射频装置的实验效果，评价射频治疗肝癌的疗效。[材料和方法] 1、采用国产集束高频电针和国产GD350型高频电刀仪与美国达隆公司RF2000伞形多弹头电极和射频仪进行离体猪肝实验对照。对国产和国外装置实验结果采用配对t检验比较，对超声引导下测量的坏死范围与术后测量坏死范围进行相关分析。2、42例肝癌患者在超声引导下，将RF2000伞形多弹头电极及国产集束高频电针刺入肿瘤内进行射频治疗。3、其中16例肝癌患者于治疗前24h、治疗后24小时、48小时、72小时及30天抽外周血离心后检测血清IL-6(sIL-6)含量。[结果] 1、国产装置与国外装置离体猪肝凝固坏死体积差异无统计学意义(t=0.53，p＞0.05)。国产集束高频电针与国外RF2000伞形多弹头电极的热凝固坏死体积差异无统计学意义(分别为t_1=0.36，p＞0.05；t_2=0.16，p＞0.05)。超声测量坏死范围与术后剖视测量坏死范围有较好的相关性(r=0.67，p＜0.01)。2、42例肝癌患者经过治疗，肿瘤完全缓解率和部分缓解率占73.4％，半年生存率为92.8％(39/42)，1年生存率为73.8％(31/42)。2例出现肿瘤细胞针道种植转移，1例胆道出血，1例皮肤灼伤，其他未见严重并发症。3、射频治疗前后进行外周血sIL-6检测的16例肝癌患者，治疗前其肿瘤体积与sIL-6水平呈正相关(r=0.848，p＜0.05)，13例无术后严重并发症患者sIL-6于术后24～48小时持续升高，术后72小时开始下降，术后30天稳定，治疗前后各组sIL-6水平差异有显著性意义(p＜0.01)。[结论] 1、国产装置与国外装置相比实验效果相近，但国产装置价格低廉，成本/效果比好。2、超声引导下射频治疗肝癌是一种安全、有效的方法。3、sIL-6可预测肝癌射频治疗后的疗效及预后。
[Objective] To study the feasibility of using the domestic cluster electrode needles and the heating coagulation therapeutic device, compare the experimental effect of the foreign and the domestic appliances, evaluate the effect in the treatment of hepatic carcinoma by radiofrequency. [Materials and Methods] 1 The ex vivo experiment results of the domestic electrode needles and GD350 electrotome were compared with RF2000 cluster electrode needles and its generator. The experiment results were analyzed by paired sample t test. The ranges of coagulation measured by ukrasonography were correlated with naked eye. 2 RF2000 radiofrequency device was used after KF electrod needles being placed into hepatic tumors under the guidance of ultrasonography in 42 patients with hepati-. carcinoma. 3 sIL-6 concentration were measured in 16 cases before therapy and after 24h, 48h, 72h, 30d. [Results] 1 The coagulation necrosis volume of ex vivo pig livers was not significantly different between two devices (t=0.53,p>0.05) . The necrosis volume resulted from domestic cluster electrode needles was not significantly different from that of the RF2000 cluster electode needles (t1=0.36, t2=0.16 p>0.05) . The dimaters of coagulation measured by ultrasound was correlated with those measured with naked eye (r=0.67,p<0.01) . 2 42 patients with hepatic carcinoma were treated. Complete and partial remission of hepatic tumor accounted for 73.4%. 6 month and 1 -year survival rates were 92.8%(39/42), 73.8%(31/42), respectively. No serious complication were encountered except for 2 cases of tumor cell seeding along the needle tract, one biliary tract hemorrhage, one skin cauma. 3 The sIL-6 level changes of 16 patients with hepatic carcinoma were analyzed. The tumor volume was positive corretation with sIL-6 (r=0.848,/K0.05) . After 24h, 48h of RITA in 13 patients with no serious complication, sIL-6 level was up. After 72h, it began to decrease. After 30 days, it was constant. The difference between before and after therapy was significant (p<0.01). [Conclusions] 1 The experiment efficiency is similar. The C/E of domestic appliance was good. The price was lower. 2 It is a safe and efficient method to treat hepatic carcinoma with radiofrequency by ultrasound guided. 3 sIL-6level could predict the therapeutic efficacy and prognosis.
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