超声介入冷循环微波消融治疗肝癌的临床价值研究  

Clinical value of ultrasound-guided cold circulation microwave ablation in treatment of liver cancer

作　　者：余松远[1] 屈亚莉 周健[2] 邓远[1] 郭丽燕[1] 

机构地区：[1]武汉市医疗救治中心超声介入科,430023 [2]武汉科技大学附属天佑医院感染科

出　　处：《临床超声医学杂志》2011年第7期440-442,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的观察超声引导下冷循环微波消融治疗肝癌的临床价值。方法在超声引导下对不能行常规手术治疗的45例肝癌患者进行冷循环微波消融治疗。治疗后定期对所有患者进行超声造影、CT增强和肝脏功能血清学指标（丙氨酸转氨酶和总胆红素）及肝癌血清学指标甲胎蛋白（AFP）变化情况检测，并随访观察1年以上。结果45例患者肝癌病灶微波消融区经超声造影、cT增强检查，消融病灶区均无明显强化，其中治疗前24例患者血清AFP有异常升高，术后3个月复查明显下降，且差异有统计学意义（P〈0．01）；术后3个月复查患者血清丙氨酸转氨酶和总胆红素，均较治疗前下降，但差异无统计学意义（P〉0．05）。随访1年后，术后存活12个月以上者37例，3—11个月者7例，占15．6％（7／45），1例失访。7例死亡患者中，2例死于消化道反复出血，5例死于肝功能衰竭。术中和术后均未出现严重并发症。结论超声引导下冷循环微波消融治疗肝癌具有疗效好、并发症少和安全性高的特点，尤其适用于不能行常规手术切除治疗的患者。Objective To observe the clinical value of ultrasound - guided cold circulation microwave ablation in treatment of liver cancer. Methods Ultrasound - guided cold circulation microwave ablation was performed on 45 patients with liver cancer who couldn＇t be treated by conventional surgery. The contrast-enhanced ultrasound （ CEUS ） , computer tomography （CT） enhancement, serum alanine aminotransferase, total bilirubin and alpha fetoprotein（AFP） of all the patients were followed up more than 1 year. Results After treatment, there was no significant enhancement of liver cancer lesions by CEUS and CT. The serum AFP of 24 patients was increased before treatment, and decreased 3 month after treatment, there was significant difference （P 〈0.01 ）. The levels of alanine aminotransferase and total bilirubin were decreased 3 month after treatment, there was no significant difference （ P 〉 0. 05 ）. Thirty - seven cases survived for more than 12 months, 7 cases survived for 3 - 11 months, l case was lost to follow up. Two patients were died of recurrent gastrointestinal bleeding, 5 patients were died of liver failure. There were no serious intraoperative or postoperative complications appeared. Conclusion Ultrasound - guided cold circulation microwave ablation is a method with good efficacy, fewer complications and high security, especially for patients who can not be treated by routine surgery.

关 键 词：超声介入 冷循环 微波 消融 肝癌 

分 类 号：R815[医药卫生—放射医学] R735.7[医药卫生—临床医学]