微波消融治疗肝癌肝移植术后肝内复发13例疗效分析  

Microwave ablation in the treatment of intrahepatic recurrence of hepatocellular carcinoma after liver transplantation:An analysis of 13 cases

作　　者：吴盼盼[1,2] 陆文[2] 孙爱学[2] 沈强[2] 王能[2] 盛月红[2] 钱国军[2] 

机构地区：[1]苏州大学研究生院,江苏苏州215123 [2]第二军医大学附属东方肝胆外科医院微创一科,上海200438

出　　处：《中国实用外科杂志》2014年第8期765-767,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨肝癌肝移植术后肝内复发行微波消融术（PMCT）的有效性与安全性。方法回顾性分析2005年8月至2013年10月第二军医大学附属东方肝胆医院行PMCT治疗的13例肝癌肝移植术后病人的临床资料,综合分析病灶的完全消融率、肝内复发率,6个月、1年、1.5年、2年存活率,以及并发症的发生率,评价其安全性和有效性。结果术后随访3～26个月。术后局部完全消融率92.3%,肝内复发率53.8%。6个月、1年、1.5年、2年的生存率分别为92.3%、53.8%、38.5%、30.8%,平均存活时间为12.8（3.5～25.6）个月。不良反应如发热1例（7.7%）,恶心、呕吐1例（7.7%）、右上腹术区疼痛2例（15.5%）,无其他并发症的发生。结论 PMCT术治疗肝癌肝移植术后肝内复发近期疗效较好,除轻度不良反应外,无严重并发症发生,病人耐受性较好,是一种安全有效的治疗方式。Objective To explore the effect and safety of percutaneous microwave coagulation therapy（PMCT） in the treatment of intrahepatic recurrence of hepatocellular carcinoma after liver transplantation. Methods The clinical data of 13 cases of liver cancer after liver transplantation performed PMCT from August 2005 to October 2013 in Eastern Hepaticbiliary Surgery Hospital of the Second Military Medical University were analyzed retrospectively. The complete ablation rate of the lesion,intrahepatic recurrence rate,6 months,1.0 year,1.5 years,2.0 year survival rate and incidence of complications were analyzed comprehensively to evaluate the safety and effect of PMCT. Results All the cases were followed up for 3-26 months. Postoperative local complete ablation rate was 92.3 %. Intrahepatic recurrence rate was 53.8%. Six months,1.0 year,1.5 years,2.0 years survival rates was 92.3 %,53.8 %,38.5 %,30.8 %. The average survival time was 12.8（3.5-25.6）months. Adverse reactions included fever in 1 case（7.7%）,nausea and vomiting in 1 case（7.7%）,right upper quadrant pain in 2 cases（15.5%） and no other complication occurred. Conclusion PMCT is a safe and effective treatment for intrahepatic recurrence of hepatocellular carcinoma after liver transplantation. The patient is well tolerated because of a mild adverse reaction and no other complication.

关 键 词：肝癌 微波消融 肝移植 肝内复发 

分 类 号：R6[医药卫生—外科学]