CT引导微波治疗原发性肝癌的并发症分析  

Complications of CT-guided percutaneous microwave coagulation therapy for hepatocellular carcinoma

作　　者：郭晨阳[1] 胡鸿涛[1] 黎海亮[1] 杜峰[1] 宋涛[1] 宗登伟[1] 

机构地区：[1]河南省肿瘤医院放射科

出　　处：《实用医学杂志》2010年第13期2356-2358,共3页The Journal of Practical Medicine

基　　金：河南省科技攻关项目(编号:0424410021)

摘　　要：目的：分析cT引导经皮穿刺微波热凝固治疗原发性肝癌的并发症及预防措施。方法：在CT引导下．微波热凝固治疗原发性肝癌患者98例，共治疗223次，治疗肿瘤数目127个。微波频率2450MHz，输出功率40。80w．持续时间5～30min。结果：患者随访4～50个月，平均随访33个月，随访中28例（28．6％）存活．66例（67.3％）死亡，4例（4．1％）失访。1、2、3年的累计生存率分别为68．4％（67例），41．8％（41例），27．6％（27例）。发生较严重的并发症5例，包括腹腔内出血1例，胆汁瘤形成1例，肝脓肿1例，十二指肠穿孔1例．急性腹膜炎1例。1例死亡与微波治疗相关。结论：CT引导微波治疗原发性肝癌有效、微创、并发症少．术前预防性治疗、术中熟练操作可减少或避免并发症的发生。Objective To analyze the complications and their preventive measures of CT-guided pereutaneous microwave coagulation therapy for hepatocellular carcinoma. Methods CT-guided percutaneous microwave coagulation therapy was performed to treat 98 patients （127 nodules） of hepatocellular carcinoma for 223 times. The microwave energy was set at 2 450 MHz and at 40 ~ 80 watt for 5 - 30 min. Results 28 patients were alive and 66 patients died after having been followed-up for 4 - 50 months. The 1-, 2-, 3-years cumulative survival rate was 68.4%, 41.8% and 27.6% respectively. Five complications were observed including intraabdominal hemorrhage in one cases, biloma in one cases, liver abscess in one case, duodenum perforation in one csae and acute peritonitis in one case. One patient died which is correlated with CT-guided percutaneous microwave coagulation therapy. Conclusion CT-guided percutaneous microwave coagulation therapy is an effective and minimally invasive treatment with less complications for hepatocellular carcinoma. Preoperative use of medicine and skilled operation may reduce or avoid the occurrence of the complications.

关 键 词：肝肿瘤 CT引导 微波热凝固治疗 并发症 

分 类 号：R735.7[医药卫生—肿瘤]