超声引导微波凝固治疗原发性肝癌——附120例临床疗效分析

Treatment of hepatocellular carcinoma by sonographically guided microwave coagulation: 120 cases clinical analysis

目的分析超声引导微波凝固治疗原发性肝癌（ＨＣＣ）的疗效。方法１２０例ＨＣＣ经皮穿刺植入单导或双导微波天线对肿瘤进行一次整体覆盖原位凝固灭活治疗。结果治疗后随访３～６０个月，肿块内血流信号消失率９０．４％，增强ＣＴ或ＭＲＩ治疗后无强化率９１．５％，ＡＦＰ转正常水平占８６．２％，肿块缩小率６１．１％，再活检肿瘤完全坏死率９０．６％，局部及全身免疫均明显增强，总生存率７８．３％。结论超声引导经皮穿刺微波凝固一次整体原位灭活治疗肝癌方法简单、省时、安全，微波热场可控、凝固效果确切，其增强免疫的效果可能为改善远期疗效的重要原因。

Objective\ To evaluate the effect of percutaneous microwave coagulation on hepatocellular carcinoma(HCC). Methods\ 120 cases with HCC were treated by using single or double implanted microwave electrodes to reach the aim of eliminating the tumor in situ at one stroke. Results\ During the follow up period of 3￣60 months, the intratumoral blood flow disappeared in 90.4%, the lesions became smaller in 61.1% and 91.5% of tumors showed no enhancement on contrast enhanced CT or MRI. In 87 patients with an elevated AFP level, the level decreases in 86 and was nomalized in 75(86.2%). A post treated biopsy on 64 patients showed complete destruction of tumor in 90.6%. The immune function on local and whole body were stimulated and activated post treatment. The total survival rate was 78.3%. Conclusions\ Sonographically guided percutaneous microwave coagulation in situ at one stroke is a way of simple, taking short time and safe for HCC treatment and the thermal field can be controlled accurately, the effect was satisfactory. The effect of enhancement immune function could be one of important fact for improving the long period clinical effect.