摘要
目的：探讨超声引导下经皮穿剌间质激光凝固肝组织方法的可行性及其在临床肝癌治疗中的应用价值。方法：８只健康犬肝超声引导下分６４个点凝固，能量范围选择２～６Ｗ，作用时间１５～４０分钟，同时于距光纤１．０和１．５ｃｍ处测温。临床对２３例肝癌的３２个结节行双光纤导入局部治疗。结果：实验证明，Ｎｄ：ＹＡＧ激光输出功率４～５Ｗ，作用２０～３０分钟，可形成一直径１．５ｃｍ左右的完全性凝固坏死区，而对应的周边温度为４８～５２℃。临床随访２５～３６个月，平均２８个月，１，２，３年生存率分别达到１００％，７３％和５２％。９例治疗后３个月再次活检，７例肿瘤呈完全性坏死，代之以纤维结缔组织增生。结论：超声引导下经皮激光凝固治疗肝癌安全可靠，并发症低，对小病灶性肝癌可以达到肿瘤完全性坏死的较好疗效，远期效果比较满意。
Objective: To find a feasible method of laser coagulation to
hepatic tissue under the ultrasound guide and its treatment for hepatic cancer. Methods: In
animal experiment,the livers of 8 healthy dogs were tested,each liver was divided into 64
points to be coagulated with Nd:YAG laser,2-6 W for 15-40 min.At the same time,the
temperatures were measured at 1.0 cm to 1.5 cm from laser tip.Clinically,the 32 hepatic nodules
in 23 cases with hepatic cancer were coagulated with double optical fiber in laser. Results: The
experiment showed that hepatic necrosis with a diameter of 1.5cm was formed with 4-5 W laser
for 20-30min,its temperature of surrounding area reached to 48-52.On clinical obsevration,the
period of followed up in 23 cases was 25-36 months,28 months averagely.The survival rate of
these patients after 1,2,3 years of coagulation was 100%,73% and 52% respectively.Among
them,9 cases were biopsy again after three months of treatment.The result showed that the
tumor focuses of 7/9 cases were completely necrosis and fibrosis. Conclusion:WTBZIt is
suggested that the Nd:YAG laser coagulation is a safe,simple and less-complication therapy for
small tumors.The effect of long-term is satisfactory.
出处
《中华理疗杂志》
1999年第3期158-160,共3页
Chinese Journal of Physical Therapy
