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目的 探讨肝癌深度冷冻治疗围手术期并发症。方法 应用LCS 2 0 0 0型深度冷冻治癌机治疗肝癌患者 6 5例 ,男性 6 0例 ,女性 5例 ,年龄 2 6～ 72岁 ,中位年龄 5 4 8岁 ,癌灶直径小于 5cm16例 ,5～ 10cm 2 4例 ,大于 10cm 2 5例。其中原发性肝癌 5 4例 ,国际TNM分期Ⅱ期 12例 ,Ⅲ期 14例 ,Ⅳa期 2 2例 ,Ⅳb期 6例。乙肝表面抗原 (HBsAg)阳性率 94% (5 1/ 5 4) ,甲胎球蛋白 (AFP)阳性率 70 %(38/ 5 4)。继发性肝癌 11例 ,原发癌为结肠癌 4例、直肠癌 2例、胆囊癌 2例、胰腺癌 1例、乳腺癌 1例、后腹膜平滑肌肉瘤 1例。结果 全组围手术期并发症 13例 16个 ,并发症发生率 2 0 % (13/ 6 5 )。包括术后腹内出血 3例、肝功能衰竭 3例、上消化道出血 6例、感染 4例。结论 肝癌深度冷冻治疗为部分不能手术切除的患者提供了有效的治疗手段 ,但应严格掌握手术适应证
Objective To explore the perioperative complications of deep cryotherapy of liver cancer. Methods Sixty-five patients with hepatocellular carcinoma were treated with LCS 200 deep cryotherapy and cancer treatment machine. There were 60 males and 5 females. The age ranged from 26 to 72 years. The median age was 448 years. The diameter of the lesion was less than 5 cm. 5 to 10cm 2 in 4 cases, greater than 10cm 2 in 5 cases. There were 54 cases of primary liver cancer, 12 cases of international TNM stage II, 14 cases of stage III, 22 cases of stage IVa, and 6 cases of stage IVb. The positive rate of hepatitis B surface antigen (HBsAg) was 94% (51/54), and the positive rate of alpha fetoprotein (AFP) was 70% (38/54). In 11 cases of secondary liver cancer, the primary cancer was colon cancer in 4 cases, rectal cancer in 2 cases, gallbladder cancer in 2 cases, pancreatic cancer in 1 case, breast cancer in 1 case, retroperitoneal leiomyosarcoma in 1 case. Results There were 16 cases of perioperative complications in 13 cases and the complication rate was 20% (13/65). Including intra-abdominal bleeding in 3 cases, liver failure in 3 cases, 6 cases of upper gastrointestinal bleeding, infection in 4 cases. Conclusion The deep cryotherapy for liver cancer provides an effective treatment for some patients who cannot be surgically removed, but strict indications for surgical indications should be obtained.