Inverventional Therapy Study On Transcatheter Arterial Chemoembolization Of Hepatic Carcinoma Combined With Radio Frequency Ablation

Objective:To evaluate the treatment effects of radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatic carcinoma and the histopathological changes of hepatic tissue after radiofrequency ablation.Then summarize the relevant experience and find the safty radiofrequency ablation way for special located hepatic carcinoma.Materials and Methods:1,Clinical Research:Case selection:the patients diagnosed with hepatocellular carcinoma were included in this study,without severe impairment of liver function and severe infection or failure of more organs.Treatment group:23 patients,diagnosed with hepatocellular carcinoma recently.Radiography images and biochemical indicators of all patients were collected before operation.Transcatheter arterial chemoembolization were taken first and RFA were taken fortnightly.Radiography images and biochemical indicators were examined every month in the followed period.Corresponding therapy would taken if abnormal things were found.Control group:40 cases of patients who were treated with TACE before.Compare postoperative recurrence of the two groups in one month and then determine the effciency.2,Ablation experiment of exvivo pork liver:RFA were taken for six fresh exvivo pork livers,and then evaluate the effect of ablation by pathological methods.3,Carbon dioxide gas separation experiments on protection of surrounding tissues One patient whose tumor close to kidney was separated by carbon dioxide gas when RFA was taken.The protection effect of carbon dioxide gas separation for kidney was observed.Result:1,AFP levels of 23 patients were lower than before,the value of ALT and AST had no significant changes.RFA treatment had been proved safe and effective.2,3 patients in treatment group suffered recurrence in postoperative one month, including two cases being controled stability and one case with bone metastasis.15 cases of patients in control group suffered recurrence in one month after operation. Through chi-square test,we know the treatment-effciency of the treatment group are better than the control group.3,On postoperative evaluation of patients,DSA has an advantage to MRI,and MRI outweigh CT.4,There are little Bile duct destruction near ablation center above 2.5,One case of patient with tumors near the kidney was ablated after carbon dioxide gas separation.The renal function showed no significant change 3 days later,all levels were in the normal range,and having no special complications.Conclusion:1,Effciency of TACE combined with RFA therapy is identified and is better than only TACE therapy.2,TACE combined with RFA therapy is safe and reliable.3,About alliance time,if the condition is permited,the best therapy opportinty is one week after TACE.4,On alliance way,we suggest first TACE then RFA.5,To recheck after operation,MRI is prefer to CT,but there exist limitation.So it is necessary to combine lab test and clinic menifestation.6,Ultrasound guiding is exact,but the air result from therapy is bad for observation and the second localization.CT observation is precise but the first puncturation's success ratio is lower.Associating these two way can complement each other,reduce the patient's pain,and increase curative effect.7,The study that Carbon dioxide gas is a conservation medium need to uncover deeply.