人工胸腹水对肝癌经皮微波消融治疗的影响  

The Effect of Artificial Pleural Effusion or Ascites for Percutaneous Microwave Ablation for Hepatocellular Carcinoma

作　　者：丁建民[1,2] 经翔[1,2] 王彦冬[1,2] 蔺琳 张倩华[1,2] 

机构地区：[1]天津市第三中心医院超声科 [2]天津市人工细胞重点实验室,天津市300170

出　　处：《中国超声医学杂志》2013年第12期1086-1090,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨人工胸腹水对超声引导经皮微波消融（MWA）治疗肝细胞癌（HCC）的临床价值.方法 106例HCC患者148个病灶中110个在人工胸腹水辅助下完成MWA治疗,治疗后定期随访.病灶大小为0.8～6.0cm,平均（2.8±1.2） cm,病灶位于S1、S2、S3、S4、S5、S6、S7、S8的数目分别为0、0、12、2、14、34、20、28个.结果 人工胸水辅助完成治疗8例8个病灶;人工腹水辅助完成治疗98例102个病灶.治疗后1个月增强CT/MRI检查,完全消融率98.2％ （108/110）.随访4～42个月,局部复发率11.1％ （12/108）,6、12、24、36个月累积局部复发率为2.8％、12.6％、34.5％、34.5％.全组病例未出现死亡和严重并发症.结论 人工胸腹水能安全、有效地辅助超声引导经皮MWA治疗HCC,扩大了超声引导经皮MWA的适应证,有助减少严重并发症的发生.Objective To explore the clinical value of artificial pleural effusion or ascites of percutaneous ultrasound-guided microwave ablation （MWA） for hepatocellular carcinoma （HCC）.Methods One hundred and ten lesions in 106 patients with 148 lesions were included in this study.All the patients were followed up regularly.The average largest diameter of the lesions was （2.8±1.2） cm.There were 0,0,12,2,14,34,20,28 lesions located in S1,S2,S3,S4,S5,S6,S7,S8,respectively.Results Eight lesions in 8 patients received percutaneous ultrasoundguided MWA with artificial pleural effusion while 102 lesions in 98 patients underwent percutaneous ultrasound-guided MWA using artificial ascites.Contrast-enhanced CT scan in one month after treatment showed that the complete ablation rate was 98.2% （108/110）.The local recurrence rate was 11.1% （12/108） during the follow-up period which were 4～42 months and the cumulative local recurrence rates at 6,12,24 and 36 months were 2.8%,12.6%,34.5%,34.5%,respectively.No death or the major complications occurred.Conclusions The artificial pleural effusion and ascites are safe and effective for treating HCC with percutaneous ultrasound-guided MWA.The technique can not only widen the indications of percutaneous ultrasound-guided MWA,but also help to decrease major complications.

关 键 词：微波消融 肝细胞癌 人工胸水 人工腹水 

分 类 号：R735.7[医药卫生—肿瘤]