大功率微波消融对中晚期肝癌的近期疗效观察  

Recent effect of high power microwave ablation in the treatment of advanced hepatocellular carcinoma

作　　者：冯建新[1] 高万河 蒋俊[1] 李俊杰[1] 刘曙民 

机构地区：[1]宝鸡市人民医院介入科,陕西宝鸡721000

出　　处：《实用放射学杂志》2015年第12期2025-2028,共4页Journal of Practical Radiology

摘　　要：目的 探讨大功率微波消融对中晚期肝癌的近期疗效，评价其安全性，分析影响肝癌术后复发的危险因素。方法 对40例原发性肝癌患者（病灶数53个）进行大功率微波消融治疗，消融时间2-10 min。术后24-48 h做增强CT判断消融效果，术后2、6月时分别做增强CT或MRI检查肿瘤复发情况，采用χ2检验对肝癌术后复发进行单因素分析。结果 〈5 cm的肿瘤经过1次或2次治疗，总消融率为100%；≥5 cm的肿瘤总消融率为85.7%。术后12例患者诉肝区疼痛，30例患者出现发热，2例患者出现右侧胸腔积液。所有患者无死亡，无大出血、肝脓肿、皮肤灼伤、针道种植转移等并发症发生。小肝癌术后6个月无局部复发，3-5 cm的肿瘤术后复发率为28.9%（11/38），＞5 cm的肿瘤术后复发率为42.9%（3/7）。肿瘤大小、病灶个数、病灶部位、术后甲胎蛋白变化、HBV携带是影响肝癌术后复发的危险因素。结论 大功率微波消融治疗中晚期肝癌是一种安全、有效的治疗方法，值得推广。Objective To investigate the recent effect and the safety of high power microwave ablation in the treatment of ad vanced hepatocellular carcinoma, and to analyze the risk factors of tumor recurrence. Methods 40 primary hepatocelluiar carcinoma patients with 53 lesions were treated with high power microwave ablation, Ablation time ranged from 2 to 10 minutes. Enhanced CT was used to evaluate the ablation effect in 24-48 hours after the operation. Enhanced CT or MRI was used to detect the recurrence at 2 months and 6 months after surgery. Chi-square test was used to single factor analysis of postoperative recurrence. Results The ablation rate of the tumors smaller than 5 cm was 100% after once or twice treatment. The ablation rate of the tumors equal or bigger than 5 cm was 85.7%. After operation, 12 patients complained of pain, 30 patients had fever, and 2 patients had right pleural effusion. All patients had no death, no major bleeding, liver abscess, skin burn, needle road planting and other complications. For small hepatocellular carcinoma, no local recurrence was found at 6 months after surgery. The recurrence rate was 28.9 % （11/38） in the tumors with the size of 3-5 cm and 42.9% （3/7） in the tumors bigger than 5 cm, respectively. Tumor size, number of lesions, lesion location, postoperative AFP change and HBV were the risk factors of tumor recurrence after surgery. Conclusion High power microwave ablation is a safe and effective method in the treatment of advanced hepatocellular carcinoma. It is worth promoting.

关 键 词：中晚期肝癌 微波消融 近期效果 影响因素 

分 类 号：R735.5[医药卫生—肿瘤] R815[医药卫生—临床医学]