目的：评价经皮射频消融术（RFA）治疗复发性肝癌的疗效及安全性。 方法：回顾性分析2008 年5 月—2014 年3 月期间79 例行经皮RFA 治疗的肝癌复发患者临床资料， 79 例患者复发病灶共106 个，病灶大小0.8~5.0 cm，平均（2.8±1.0）cm。 结果：消融治疗成功率为98.1%，肿瘤完全消融率94.2%。术后常见不良反应为发热（72.7%）、肝区疼痛 （90.9%）、胃肠道症状（20.8%）、黄疸（6.5%），无肝功能衰竭、胆瘘、感染、出血等严重并发症，无 围手术期死亡病例。术后住院时间1~5 d，平均（2.2±1.0）d。术后随访7~64 个月，平均（38±14）个月， 54 例出现复发，复发率70.1%。术后1、3 年生存率分别为89.6%、66.2%。 结论：经皮RFA 治疗复发性小肝癌是一种安全有效的微创治疗方法，可优先考虑作为该病治疗的术式 选择。
Application value of radiofrequency ablation in treatment of recurrent hepatocellular carcinoma
Objective: To assess the efficacy and safety of percutaneous radiofrequency ablation (RFA) in treatment of recurrent hepatocellular carcinoma (HCC). Methods: The clinical data of 79 patients with recurrent HCC undergoing percutaneous RFA from May 2008 to March 2014 were retrospectively analyzed. There were a total of 106 recurrent lesions in the 79 patients, and the tumor size ranged from 0.8 to 5.0 cm with an average of (2.8±1.0) cm. Results: The success rate of ablation was 98.1% and a complete tumor ablation rate reached 94.2%. The common post-ablation adverse reactions were fever (72.7%), pain in hepatic region (90.9%), gastrointestinal symptoms (20.8%), and jaundice (6.5%). No severe complications such as liver failure, bile leakage, infection, and bleeding occurred, and no perioperative death occurred as well. The length of postoperative hospital stay was 1 to 5 d with an average of (2.2±1.0) d. Follow-up was conducted for 7 to 64 months with an average of (38±14) months, post-ablation recurrence occurred in 54 cases, and the recurrence rate was 70.1%. The 1- and 3-year post-ablation survival rate was 89.6% and 66.2%, respectively. Conclusion: Percutaneous RFA is a safe, effective and minimally invasive treatment method for small recurrent HCC, and should be considered as a preferential alternative for this condition.