超声引导下经皮肝穿刺冷循环微波和冷循环射频治疗肝癌的临床比较  

Ultrasound-guided ablation therapies for liver cancer: a comparison between microwave and radiofrequency with cooled-tip electrode

作　　者：张秀国[1] 宋晓军 

机构地区：[1]山东大学齐鲁医院普外科,山东济南250012 [2]山东省滨州市阳信县人民医院普外科,山东滨州251800

出　　处：《中国现代普通外科进展》2013年第7期530-534,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:比较超声引导下经皮肝穿刺冷循环微波(MW)和冷循环射频(RF)2种肝癌治疗方法的临床应用。方法:2004年9月—2009年1月,经皮肝穿刺冷循环MW治疗肝癌300例(MW组),共479个结节,直径0.9～11.4 cm,平均(5.8±2.2)cm。2002年4月—2009年1月,经皮肝穿刺冷循环RF治疗肝癌130例(RF组),共231个结节,直径2.2～10.1 cm,平均(5.3±1.9)cm。总结上述2种肝癌治疗方法的临床研究结果,对MW和RF的局部疗效、生存率、并发症等作初步比较分析。结果:单针穿刺消融的范围(以肝脏增强CT扫描评估消融范围)两者相同,均为长轴4.0～4.5 cm,横轴3.3～3.5 cm的类椭圆体。肿瘤完全坏死率MW组为84.1%(403/479),RF组为88.7%(198/231),两者比较差异无统计学意义(χ2=0.17,P>0.05)。1年存活率:MW组为89.0%(267/300),RF组为90.8%(118/130);2年存活率:MW组为79.0%(237/300),RF组为80.0%(104/130),两者比较差异均无统计学意义(P均>0.05)。消融治疗后,MW组和RF组出现的副反应及并发症几乎相同,且发生率差异亦无统计学意义(P>0.05)。结论:冷循环MW和RF都是比较理想的肝癌微创治疗手段,治疗效果相同。Objective： Comparing the value in clinical practice of ultrasound-guided ablation therapies for liver cancer between using microwave and using radiofrequency with cooled-pid elec-trod e. Methods： From September,2004 to January , 2009 , microwave coagulation therapy was employed to treat 300 cases of liver cancer with 479 nodules,with a diameter of 0.9- 11.4 cm E（5.8 ± 2.2）cm] ;and from April,2002 to January,2009, radiofrequency coagulation therapy was used to treat 130 cases of liver cancer with 231 nodules,with a diameter of 2.2 - 10.1 cm [（5.3 ± 1.9）cm]. Summarizing the results of the above-stated two clinical researches,a preliminary com-parison between MW and RF in local ablation effect and invasiveness was made. Results： The area of coagulative necrosis was similar, both MW and RF were 4.5 cmx3.5 cm. The tumor com- pletely ablation rate was 84.1% （403/479）in MW and 88.7% （198/231） in RF,which showed no significant difference in statistics （ X^2=0.17, P〉O.05）. The 1 year survival rate was 89.0% （267/300） in MW, 90.8% （118/130） in RF;The 2 year survival rate was 79.0% （237/300） in MW, 80.0% （104/130）in RF, P〉O.05, both showed no significant difference in statistics （P〉O.05）. There was also no difference in side effect and complication between the two ablation techniques. Conclu-sions： Both MW and RF are contemporary ideal therapeutic approaches of interventional ultra-sound for liver cancer.

关 键 词：超声检查 微波 射频 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]