超声引导经皮穿刺微波治疗恶性肿瘤的临床研究  

Clinical study on ultrasound-guided percutaneous microwave ablation for malignant tumor

作　　者：何文[1] 邬冬芳[1] 胡向东[1] 张晓蓉[1] 郭莉[1] 梁晓宁[1] 郑永才[1] 

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100050

出　　处：《中国医学影像技术》2006年第12期1860-1865,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨超声引导微波消融治疗恶性肿瘤的疗效和可行性。方法373例实体瘤(肝癌、肺癌和骨肿瘤等)进行超声引导下经皮穿刺微波消融治疗。结果所有病例治疗后全身情况好转,症状减轻或消失,患者饮食明显增加,生活质量、生存率提高,肿块缩小,肿瘤内血流消失或减少。27例超声引导下活检肿瘤完全坏死。≤5cm肝癌治疗后有效率(CR+PR)83.2%,1,2,3,5年生存率分别是88.8%,68.5%,60.9%,38.6%,一次完全消融率60.9%。>5cm肝癌有效率(CR+PR)61.9%,1,2,3,5年生存率分别是67.8%,51.7%,39.8%,24.6%,一次完全消融率36.9%。微波联合TACE治疗大肝癌1,2,3,5年生存率分别是88.6%,71.4%,60.0%,42.9%;肺癌微波治疗有效率(CR+PR)64.7%,一次完全消融67%;骨肿瘤微波治疗有效率(CR+PR)100%,一次完全消融率64.7%,疼痛减轻或消失,肢体功能恢复。无其他严重并发症发生。结论超声引导微波消融治疗肝、肺和骨肿瘤等实体瘤安全、可行、有效。Objective To evaluate the feasibility and efficiency of ultrasound-guided percutaneous microwave coagulation therapy for malignant tumor. Methods A total of 373 cases of solid carcinoma, which included 340 cases of hepatic cancer, 17 cases of lung cancer, 13 cases of bone tumor, 2 cases of kidney tumor and 1 case of adrenal tumor, were received ultrasound-guided percutaneous microwave ablation therapy. Results After the treatment, all lesions were decreased in size and blood flow in nodules disappeared. Repeated biopsy in 27 patients showed complete necroses of tumors. There was no enhancement in the tumor on enhanced CT scans. All patients were better than before, their symptoms were relief or disappearance, and the appetite were increase significantly. The effective rate （CR＋PR） was 83.2%, and the 1, 2, 3, 5 years survival rates were 88.8%, 68.5%, 60.9% and 38.6% respectively in the small hepatic cancer （≤5 cm）, whereas in the large hepatic cancer （〉5 cm）, the effective rate （CR＋PR） was 61.9%, and the 1, 2, 3, 5 years survival rates were 67. 8 %, 51.7 %, 39.8 %, and 24.6 %, respectively. The 1, 2, 3, 5 years survival rates in microwave ablation and transcatheter arterial embolization were 88.6%, 71.4%, 60.0% and 42.9% respectively. The effective rates （CR＋PR） in patients with lung cancer and bone tumor were 64.7% and 100%. Patients felt the pain disappeared or remissive and the limbs functions were recovered in the bone tumor. There were no severe complications in the patients with malignant tumor by ultrasoundguided percutaneous microwave ablation therapy. Conclusion Ultrasound-guided percutaneous microwave ablation therapy is a safe, effective and feasible method for solid carcinoma, such as hepatic cancer, lung cancer, bone tumor.

关 键 词：微波 肝肿瘤 骨肿瘤 肺肿瘤 介入性超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R730.4[医药卫生—诊断学]