超声引导下经皮肝穿刺微波消融治疗肝癌的应用体会

Ultrasound-guided percutaneous transhepatic microwave ablation therapies for liver cancer

目的：探讨冷水循环型微波（microwave,MW）热疗治疗肝癌的近期疗效及安全性。方法：用FORSEA MTC-3冷水循环型微波肿瘤热疗仪治疗肝癌患者160例,共239个结节,通过影像学检查及随访观察其疗效。结果：MW治疗区增强CT扫描检查示各期均无强化,周边可见很薄的环形强化,治疗的坏死范围要大于治疗前病灶范围。以肝脏增强CT扫描评估单针穿刺消融范围,为长轴4-4.5 cm,横轴3.3-3.5 cm的类椭圆体。肿瘤完全坏死率为84.9%（203个结节）。1年生存率为91.3%（146/160）,2年生存率为80.2%（69/86）。MW治疗肝癌并发症少,多为发热、肝功能异常、胸水等,偶见肝脓肿,无一例手术死亡。结论：MW热疗可作为肝癌的一种安全有效的微创治疗方法。

Objective：To evaluate short-term therapeutic efficacy and safety of cooled-tip electrode microwave ablation of liver cancer.Methods：One hundred and six patients（239 nodes） of liver cancer were treated with a new cooled-tip electrode microwave（FORSEA MTC-3）.The contrast-enhanced CT and follow-up were used to evaluate the short-term therapeutic efficacy.Results：The ablated area was not enhanced on contrast-enhanced CT,the tissue around ablated area was enhanced.The necrosis area after treatment was larger than tumor size before treatment.The coagulative extent after one application of MW was 4.0-4.5cm in length wise and 3.3-3.5cm in transversal wise according to contrast-enhanced CT.The tumor complete ablation rate was 84.9%（203 nodes）.The 1 year survival rate was 91.3%（146/160）,and the 2 year survival rate was 80.2%（69/86）.There were a few complications occurred such as fever,liver function abnormality,pleural fluid and liver abscess.No patients died during the process.Conclusions：The innovated MV ablation is safe and effective for mini-invasive treatment of liver cancer.