超声造影引导下微波消融治疗晚期肝脏恶性肿瘤的临床观察

Evaluation of contrast-enhanced ultrasound guided Microwave Ablation for the treatment of advanced hepatic malignant tumors

目的评价超声造影(CEUS)引导下经皮微波消融(MWA)治疗晚期肝脏恶性肿瘤的疗效及安全性。方法纳入2013年6月到2015年6月在肿瘤内科治疗的原发性肝癌或复发转移性肝癌患者50例,行CEUS引导下MWA术,随访以评估疗效和不良反应。结果 50例患者64枚病灶接受MWA治疗,成功率为100.0%。术后1个月复查CEUS,总有效率为85.9%(55/64)。患者体力状况改善率为68.0%(34/50)。全组患者平均生存时间为(10.2±3.7)个月,1年生存率为20.0%。术中主要不良反应为局部疼痛、心率下降、少量出血,均未影响治疗。术后常见有肝区疼痛、一过性转氨酶升高、发热、肝包膜下血肿,积极治疗后好转,未出现严重并发症。结论 MWA对晚期肝脏恶性肿瘤具有较好的近期疗效,操作方便,患者痛苦小,并发症轻,是一种安全有效的姑息治疗方法。

Objective To investigate the efficacy and safety of contrast-enhanced ultrasound（CEUS） guided Microwave ablation（MWA） for the treatment of hepatic malignant tumors. Methods A total of 50 patients with advanced primary hepatic cancer or recurred/metastatic hepatic cancer were enrolled from June 2013 to June 2015. MWA was carried out in all patients. The therapeutic efficacy and adverse reaction were followed up. Results 50 patients（64 lesions） received MWA treatment, the success rate was 100.0%. Total effective rate was 85.9%（55/64）. The improvement rate of performance status was 68.0%（34/50）. The mean overall survival was（10.2±3.7） months, and the 1 year survival rate was 20.0%. During operation, the main adverse reactions were local pain, decreased heart rate, small amount of bleeding, but do not cause termination of treatment. After operation, there were pain of liver area, transaminase increase, fever, liver subcapsular hematoma, no serious complications occurred. Conclusion MWA has good short-term efficiency in the treatment of advanced hepatic malignant tumors, with more convenience to operate, less suffering and adverse reaction, thus, it is a safe and effective palliative treatment.