TACE联合C臂CT引导下微波消融治疗特殊部位原发性肝癌

TACE combined with C-arm CT-guided microwave ablation in treatment of primary hepatic carcinoma on special sites

目的观察TACE联合C臂CT引导下微波消融(MWA)治疗特殊部位原发性肝癌(PHC)的效果。方法对46例特殊部位PHC患者均行TACE联合C臂CT引导下MWA治疗。术后1个月复查肝脏CT或MRI,评价治疗效果。结果46例均手术成功,共消融治疗51次,37例治疗1次,2次4例,3次2例,平均1.4次;消融时间3~5 min,平均4 min。术后21例出现腹痛、恶心、呕吐、发热等症状,给予对症处理后均缓解,未出现严重不良反应。术后1个月复查肝脏CT或MRI,44例治疗有效(病灶完全坏死40例,4例体积缩小≥10%),2例稳定,无进展病例。所有患者随访至今,均健在。结论TACE联合C臂CT引导下MWA治疗特殊部位PHC效果好,安全性高。

Objective To investigate the effect of TACE combined with C-arm CT-guided microwave ablation(MWA)in treatment of primary hepatic carcinoma(PHC)on special site.Methods Totally 46 patients with PHC on special sites were treated with TACE combined with C-arm CT-guided MWA.CT and MRI of the liver was performed 1 month after operation to evaluate the therapeutic effect.Results The operations were successfully performed in all 46 patients,including 51 times ablation,37 patients underwent one time,4 underwent two times and 2 patients underwent three times of ablation(on average 1.4 times),and the ablation time was 3-5 min(on average 4 min).After operation,symptoms of abdominal pain,nausea,vomiting and fever etc.were noticed in 21 patients and relieved after symptomatic treatment.No serious adverse reaction occurred.One month after operation,complete necrosis of the tumor was detected in 44 cases,volume reduction≥10%was found in 4 cases,tumor stable was observed 2 cases,while no tumor progressive case was found.All patients were alive so far.Conclusion TACE combined with C-arm CT-guided MWA is effective and safe in treatment of PHC on special site.