超声引导下经皮微波消融肝表面肿瘤的临床应用

Clinical application of ultrasound-guided percutaneous microwave ablation therapy in treatment of superficial hepatocellular carcinoma

目的分析超声引导下经皮微波消融(PMCT)肝表面肿瘤的疗效及相关并发症。方法 2009年10月-2011年6月85例患者共计103个紧邻腹壁的肝表面肿瘤行PMCT治疗,病灶直径0.7-8.1(4.1±2.3)cm,治疗过程中视测温情况适时调节微波辐射功率。随访3-28(11.2±4.5)个月,观察肿瘤灭活情况、肝功能及并发症。结果 1次消融肿瘤完全坏死率76.6%(79/103),2次消融肿瘤完全坏死率100%;8个病灶局部复发,局部复发率7.7%。术后46例(54.1%)出现不同程度发热,59例(69.4.1%)出现局部疼痛,3例出现腹胀,肩背部放射痛、恶心呕吐、皮肤灼伤各1例,无与手术有关的严重并发症。结论 PMCT治疗肝表面肿瘤有效、安全。

Objective To analyze the effect of ultrasound-guided percutaneous microwave ablation（coagulation） therapy（PMCT） on superficial hepatocellular carcinoma（HCC） and its complications.Methods Eighty-five superficial HCC patients（103 superficial HCC close to the abdominal wall） underwent PMCT.The diameter of HCC was 0.7-8.1cm（4.1±2.3cm）.The microwave power was adjusted during the treatment of patients according to their temperature.The patients were followed up for 3-28 months（11.2±4.5 months） during which the inactivated HCC,hepatic function and complications were observed.Results The complete necrosis rate of HCC was 76.6% and 100%,respectively,after 1 and 2 times of ablation.Local recurrence occurred in 8 foci with a recurrence rate of 7.7%.Of the patients,46 had fever,59 had local pain,and 3 had abdominal distension,nausea and vomiting,shoulder pain,and 1 had skin burning.No operation-related complication occurred.Conclusion PMCT is an effective and safe modality for superficial HCC.