CT引导经皮微波凝固治疗肝癌并发症的临床分析  

Clinical analysis of operation-related complications of CT-guided percutaneous microwave coagulation therapy of liver malignancies

作　　者：陈耀庭[1] 许林锋[1] 孙宏亮[1] 李振辉[1] 谭绮尹[1] 胡仁美[1] 

机构地区：[1]中山大学孙逸仙纪念医院介入放射科,广东广州510120

出　　处：《中国介入影像与治疗学》2009年第6期516-519,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的分析CT引导经皮微波凝固治疗（PMCT）肝癌的相关并发症发生的原因、治疗及其预防方法。方法对68例肝癌患者接受CT引导PMCT治疗后的并发症的临床资料进行回顾性分析。结果肿瘤直径为2.013.8 cm,平均6.2 cm,其中64例接受PMCT前接受肝动脉化疗栓塞（TACE）。68例患者共接受120例次PMCT治疗,术中主要不良反应是迷走神经亢进反应。发生手术相关并发症7例次,包括肝脓肿和针道种植各2例次,气胸、心血管意外和巨大胆汁瘤合并感染各1例次;6例次并发症治愈,1例次种植肿瘤进展。结论CT引导PMCT治疗肝癌的并发症少且可以防治,并发症与穿刺路径、次数、凝固范围以及围手术期处理等有关。Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy（PMCT）.Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0—13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization（TACE） was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT（1—8 times per patient）.The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients（7/120,5.83%） had complications including needle-tract implantation（n=2）,liver abscess（n=2）,pneumatothorax（n=1）,cardiovascular accident（n=1） and enormous biloma with infection（n=1）,6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.

关 键 词：经皮微波凝固治疗 肝肿瘤 并发症 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]