微波固化治疗肝癌术后复发的应用价值(附30例报告)

The Clinical Value of Microwave Coagulation in the Treatment of Recurrent Hepatocellular Carcinoma: A Report of 30 Aases

目的:探讨在超声引导下微波固化治疗肝癌术后复发的临床应用价值。方法:肝癌术后复发病人30例共54个癌结节,使用UMC—1型微波仪,在超声引导下经皮穿刺对肿瘤进行整体覆盖一次性原位固化灭活。结果:全组随访18个月,经彩超复查瘤内血流消失者占96.7％,AFP下降者占94％,下降至正常者占70.5％,增强CT检查示肿瘤内未见强化者占96.7％,18个月生存率为80％,生存者生活质量良好。结论:超声引导下经皮穿刺微波固化治疗肝癌的方法,具有热效率高、疗效确切、肝功能损害轻、并发症少、操作简单、安全可靠等特点,可望成为肝癌术后复发,尤其是肝内≤3.5cm的一种极有效治疗单个癌结节。

Objective: To study the clinical value of ultrasound - guided microwave coagulation in the treatment of recurrent hepatocellular carcinoma. Methods: 30 recurrent hepatocellular carcinoma patients with total of 54 tumor nodules in the liver were collected and summarized. All patients were treated percutaneously by one shot microwave coagulation under the guidance of B-type ultrasound. Results: All of 30 patients were followed-up 3 to 18 months (mean time: 16.4months), Among the whole nodules, the intratumoral blood detected by color - ultrasound disappeared in 96.7% , alphafetoprotein(AFP) decreased in 94.0% and recovered to normal in 72.2%,no contrast medium enhancement appeared in 96.7% during CT examination. The 18 month survival rate was 80% and the patient's life quality was good. Conclusion: There were many advantages to treat postoperative liver cancer recurrence using percutaneous ultrasound - guided microwave coagulation, such as high heat -efficacy, curative effect, minor damage to liver function, few complication, ease and safety to manipulate, etc. Microwave coagulation may be one of the most effective measures for the postoperative liver cancer recurrence, especially for those nodules less than 3.5 cm in diameter.