高强度聚焦超声治疗尾状叶肝癌局部的疗效报道  

High-intensity Focused Ultrasound Therapy for Hepatocellular Carcinoma on the Caudate Lobe: A Preliminary Report of the Local Efficacy

作　　者：申权[1] 薛焕洲[1] 褚学宏[1] 马芳[1] 

机构地区：[1]河南省人民医院肝胆外科,450003

出　　处：《中国医药指南》2009年第10期44-45,共2页Guide of China Medicine

摘　　要：目的探讨非麻醉状态下高强度聚焦超声（HIFU）治疗尾状叶肝细胞性肝癌（HCC）的局部疗效及其影响因素。方法2008年2月至2009年4月应用HIFU治疗了16例尾状叶HCC患者，癌灶直径19．4-96．9mm，平均（32.3±18．4）mm，每个癌灶治疗3次。主要用造影CT评价肿瘤灭活效果和局部复发，观测治疗前后肝功能和甲胎蛋白（AFP）的变化。结果16个癌灶经HIFU治疗后完全灭活10个，灭活率62．5％。完全灭活癌灶的体积和单位有效热剂量分别为33828．4±7713．4、9．27±2．22J／mm^3，而未完全灭活癌灶则分别为87330．6±15964．2、2．51±0．42J／mm^3，差异有统计学意义。HIFU治疗后谷丙转氨酶无升高，AFP明显下降，无皮肤烧伤。结论HIFU对尾状叶HCC能够获得较好的局部治疗效果，无明显不良反应。癌灶体积和单位有效热剂量影响HIFU对癌灶的灭活。Objective To evaluate the efficacy of high-intensity focused ultrasound （HIFU） in the treatment ofhepatocellular carcinoma on the eaudate lobe. Methods Sixteen patients with hepatocellular carcinoma on the caudate lobe were treated by HIFU. The diameter of lesions was ranged from 19.4mm to96.9 mm （mean, 32.3mm±18.4mm）, Each patient was treated with three to six sessions. Contrast-enhanced CT was employed to assess the therapeutic efficacy at one moth after treatment. The changes in liver function and serum AFP were monitored following treatment. Results During a follow-up time of 1.0 to 11.5 months （median, 6 months）, complete destruction was observed in 62.5% of lesions （10/16）. The volume of completely and no-completely destructed lesion were 33828.4±7713.4J/mm^3 and 87330.6±15964.2J/mm^3, respectively, and the energy of HIFU percubic millimeter were 9.27±2.22J/mm^3 and 2.51±0.42J/mm^3, respectively. No remarkable changes in liver function was observed and serum AFP decreased after therapy. Ransient mild burning pain at the site of target region during treatment represented the most common side effect, and mild fever might occur in some patients after therapy. Conclusion HIFU was able to completely destroy the hepatocellular carcinoma on the caudate lobe with no marked side effects. It implied that HIFU represented a promising modality for the hepatocellular carcinoma on the caudate lobe.

关 键 词：超声治疗 高强度聚焦超声 癌 肝细胞性 

分 类 号：R735.7[医药卫生—肿瘤]