B超引导下冷循环微波刀治疗肝癌的价值:附116例报告  

Clinical value of B ultrasound-guided psychro-circulation percutaneous microwave coagulation therapy (PMCT) in treating liver cancer:a report of 116 cases

作　　者：张小红[1] 李坚[1] 张波[2] 黄铁汉[2] 

机构地区：[1]中南大学湘雅医院肝胆肠外科,湖南长沙410008 [2]中南大学湘雅医院超声科,湖南长沙410008

出　　处：《中国普通外科杂志》2008年第7期697-699,共3页China Journal of General Surgery

摘　　要：目的探讨B超引导下冷循环微波刀治疗肝癌的临床价值。方法对近年收治的116例肝癌患者共154个病灶进行冷循环微波刀治疗,比较手术前后B超、CT监测肝癌结节的直径及血流情况和AFP值的变化,以及术后1,2,3年生存率。结果全组无严重并发症及手术死亡病例。术前血清AFP值为(421.6±36.5)μg/L,术后1个月降为(232.5±25.6)μg/L(P<0.01);术前肿瘤直径为(48.6±10.2)mm,术后1个月减为(37.5±7.8)mm(P<0.05);术后3个月肿瘤完全消失15例。明显缩小86例,无明显变化15例;原发性肝癌患者术后1,2,3年生存率分别为89.4%,67.1%,43.8%,继发性肝癌患者术后1,2,3年生存率分别为:82.1%,53.8%,24.0%。结论冷循环微波刀是治疗肝癌的有效手段,创伤小、并发症少、操作方便,尤其适用于不能手术的患者。Objective To explore the clinical value of B ultrasound-guided psychro-circulation percutaneous microwave coagulation therapy （ PMCT ） in the treatment of liver cancer. Methods One hundred and sixteen liver cancer patients with 154 lesions were selected to receive psychro-circulation PMCT in our department from July 2004 to December 2007. The pre-and postoperative alpha fetoprotein （ AFP ） levels were detected. The diameters and blood flow state of the tumors were measured and compared by use of B ultrasound and computerized tomographic scanning （ CT ）. The postoperative 1 , 2 and 3 y survival rate of those patients was followed up and recorded. Results No mortality or severe complications occurred in this series. Preoperative serum AFP level of the patients was （ 421.6 ± 36.5 ）μg/L and decreased obviously to （ 232.5 ± 25.6 ） μg/L at 1 month after psyehro-circulation PMCT （ P 〈 0.01 ）. Preoperative tumor diameter was （48.6 ± 10.2） mm and diminished to （37.5 ±7.8） mm at 1 month postoperatively（P 〈0.05）. At 3 months postoperatively, the liver tumors disappeared completely in 15 cases, obviously decreased in size in 86 cases and no marked changes occurred in 15 cases. In the patients with primary hepatic carcinoma, the postoperative 1,2 and 3 y survival rate was 89.4% ,67. 1% , and 43.8% , respectively. In the patients with secondar＇） hepatic carcinoma, the postoperative 1,2 and 3 y survival rate was 82. 1% , 53. 8% , and 24.0% , respectively. Conclusions Psychro-circulation PMCT is an effective method for treating liver cancer and is especially suitable convenient performance. for inoperable patients, because of its mini-trauma, few complications and convenient performance.

关 键 词：肝肿瘤/外科学 冷循环微波刀 B超引导 

分 类 号：R735.7[医药卫生—肿瘤]