Hepatocellular carcinoma is one of the most common malignant tumors in China, with the age of 40-60 years old, high degree of malignancy and high death rate. Especially in China, most of the patients with hepatocellular carcinoma suffer from post-hepatitis cirrhosis, and 70% of them are in middle or late stage at the time of diagnosis, which makes treatment of hepatocellular carcinoma even more tricky. Hepatocellular carcinoma patients are often characterized by fatigue, emaciation, loss of appetite; most of them have pain in right quarter rib or upper abdomen, which is often persistent and dull, mostly caused by the continuous expansion of hepatic pericardium. When rupture of tumor nodule occurs and causes blood accumulation under hepatic pericardium, there may be acute abdominal pain. In recent years, percutaneous puncture argon helium knife treatment for liver cancer has become an effective therapeutic means for treating liver cancer, which can both shrink the tumor and have good pain-relieving effect. Indications Primary, recurrent or metastatic hepatocellular carcinoma, the tumor cannot be resected by conventional surgery or the patient cannot tolerate or is unwilling to accept conventional surgery, and the liver function is evaluated as Child A or B grade. Ar-He knife treatment methods 1. Ultrasound-guided puncture: local anesthesia is used. The patient is routinely sterilized and toweled before the operation, and after local anesthesia, a small incision is made in the skin and subcutaneous tissue at the proposed puncture point. Under the guidance of ultrasound guide, argon helium knife was inserted into the tumor. Start the ultra-low temperature surgical system, freeze and thaw 2 cycles (freezing for 15 minutes – warming for 5 minutes – freezing again for 15 minutes – warming again for 5 minutes), the lowest freezing temperature can be up to about -130 ℃, and the highest warming can be up to 30 ℃. The argon helium knife was withdrawn at the end of freezing and thawing, and ultrasound was again used to observe any bleeding and other complications. Ultrasound-guided percutaneous argon-helium knife targeted treatment of liver cancer is simple and economical, and the whole freezing process and the size of ice ball and freezing range can be monitored in real time when the cold knife is placed into the target point. 2.CT guided puncture: the operation is carried out in CT room. According to the needs of surgery, the patient can adopt appropriate position. Local anesthesia is used. A localized light-san is placed on the body surface and scanned to locate the markers. Routine disinfection, local anesthesia, cut the skin 0.5 cm at the puncture point, according to the preoperative CT localization of the direction of the needle, the angle of the needle, the depth of the needle, the argon helium knife inserted into the target point of the liver tumor, the start of the ultra-low temperature surgical system, freezing and thawing of the two cycles, the end of the surgery and then again the CT scan, to further understand the effect of freezing and whether there are complications such as bleeding, pneumothorax and so on. CT-guided percutaneous argon-helium targeted cryopreservation of liver cancer has a high accuracy of target puncture, the ice ball formed by the tip of the cold knife is clearly visible, and there is a high probability that all tumors will be frozen and inactivated. Therapeutic efficacy Percutaneous puncture argon-helium knife treatment of liver cancer does not require incision, no bleeding, few complications, fast recovery, simple operation, easy to be accepted by patients and repeatable treatment. For limited tumors within 4cm in diameter, one freezing and thawing can achieve radical effect; while for tumors larger than 10cm in diameter, they need to be frozen for several times, and the freezing range of each time can reach more than 90%, so as to achieve the purpose of rapid tumor load reduction. For tumors larger than 5cm, percutaneous hepatic artery chemoembolization (TACE) combined with percutaneous cryoablation sequential treatment can be adopted. Gelatin sponge and other embolic agents are applied to embolize the proximal tumor blood-supplying arteries to interrupt or reduce the blood supply to the tumor and its surrounding, resulting in tumor necrosis, and at the same time, chemotherapeutic drugs are injected along the tumor-supplying blood vessels to further kill the tumor and shrink the tumor body. Argon-Helium knife treatment within 1 week of TACE can enlarge the freezing range (vascular blockage, no blood flow effect) and enhance the therapeutic effect. In general, the patient’s pain can be basically relieved 1 week after the operation, but there may be absorbed heat that lasts for about 1 week, which can be treated symptomatically. Ar-He knife can also be used in combination with chemotherapy, radiotherapy (125I particle implantation) and gene therapy to achieve better therapeutic effect.