超声引导下经皮微波固化治疗肝血管瘤  

The therapy of percutaneousmicrowave ablation for liver hemangiomas by ultrasonic guidance

作　　者：闫勇[1] 戴睿武[1] 汪涛[1] 叶明辉[1] 张生[1] 江宗兴[1] 王华[1] 朱永强[1] 

机构地区：[1]成都军区总医院全军普通外科中心,四川成都610083

出　　处：《四川医学》2012年第10期1715-1717,共3页Sichuan Medical Journal

摘　　要：目的探讨经皮微波固化治疗肝血管瘤的临床应用。方法经超声、CT、MRI和活检确诊的82例肝血管瘤,在超声引导下,微波针穿刺入病灶区域微波固化。15例直径>5.0cm的肝血管瘤采用多层面、多点固化,使之完全覆盖。14例多发性肝血管瘤逐个病灶微波固化,53例<5.0cm肝血管瘤一次微波固化完成。靠近大血管的病灶,DF≤0.5cm,热能从低到高,不宜>60W。结果全组微波固化后,原病灶区域超声显示强回声团,超声造影显示无血流信号,无出血、无漏胆、感染等并发症,无1例死亡,随访6～24个月56例原病灶增强CT显示不被强化,部分液化,无新生病灶。结论超声引导下经皮微波固化治疗肝血管瘤改变了手术切除是肝血管瘤治疗的唯一方法的观点。对>5.0cm和<5.0cm及多发性肝血管瘤都适用。该方法微创、安全、操作简单,并发症少。Objective To explore the clinical application of percutaneous microwave ablation for liver hemangiomas.Methods The microwave needle was punctured into focal zone under the B-ultrasonic guided to 82 liver hemangiomas patients,and all cases be performed microwave ablation.The multilayer and multidrop ablation was performed to 15 cases with hemangiomas which diameter exceed 5cm,and the 15 multiple hemangiomas cases were performed ablation one by one,and the other 53 cases＇ablation were performed one time.The DF should less than 0.5cm and heat energy should be set from low to high（less than 60W）to the focus near to the great vessels.Results The origin focus became high echo mass in ultrasonic visualization after microwave ablation,and ultrasonic opacification displayed no bloodflow signal.No complication（bleed,bile leak,and infection）happened,No patient died.The 56 cases were performed follow-up visit in 6~24 months,and CT displayed original focus cann＇t be intensified and liquated partly,without new focus.Conclusion The method of percutaneous microwave ablation for liver hemangiomas changes the views which operation is the only method to the disease.It is applicable to all types of liver hemangiomas with the merit of micro invasion,safe,simple manipulation,and few complication.

关 键 词：肝血管瘤 超声 微波固化 

分 类 号：R735.7[医药卫生—肿瘤]