探索TACE+微波消融同步治疗肝癌的临床疗效  

Clinical efficacy of concurrent TACE+microwave ablation for treatment of liver cancer

作　　者：黄永东[1] 张振岳[1] 张英[1] 蔡晓晴[1] 施海辉[1] 毛健[1] HUANG Yongdong;ZHANG Zhenyue;ZHANG Ying;CAI Xiaoqing;SHI Haihu;MAO Jian(Department of intervention of Qidong People’s Hospital&the Affiliated Qidong Hospital of Nantong University,Qidong 226200,Jiangsu Province,China)

机构地区：[1]启东市人民医院·南通大学附属启东医院介入科,江苏启东226200

出　　处：《西南医科大学学报》2020年第2期161-164,共4页Journal of Southwest Medical University

基　　金：南通市市级科技计划项目(2017-157)。

摘　　要：目的:总结并探索TACE+微波消融同步治疗肝癌的临床疗效的可行性。方法:2017年6月至2018年12月,启东市人民医院介入科治疗24例临床诊断为肝癌患者,采用TACE+微波消融同步治疗技术,先肝动脉置管,然后B超引导下置入消融针,再进行肝动脉造影检查确认病灶,微波消融治疗后再次造影评估,最后利用TACE进行肿瘤靶动脉栓塞治疗。随访周期均采用1、3、6个月。随访AFP、肝动脉、B超、CT或MRI增强检查,评价肿瘤完全坏死率,病灶部分坏死率、病灶复发率,评估疗效。结果:入组24例肝癌患者26个病灶,共行TACE+消融同步治疗24次;治疗有效率分别为100%,病灶完全坏死率分别为66.7%,AFP较术前下降率为100%,术后三月再次手术发生率,33.3%。并发症:疼痛发生率、介入术后出现恶心、呕吐、腹痛等微波术后综合征/栓塞综合征对症处理后好转,术后一周复查肝功能及血常规大多恢复正常。结论:TACE与微波消融同步治疗肝恶性肿瘤是一种有效的治疗手段。不仅提高单次治疗的疗效,而且减少了患者的痛苦,同时不良反应又在可控范围内。Objective:To investigate the feasibility and clinical efficacy of concurrent transarterial chemoembo-lization(TACE)+microwave ablation for treatment of liver cancer.Methods:From June 2017 to December 2018,24 patients who were clinically diagnosed with liver cancer and treated in the Department of Interventional Radiolo-gy in Qidong People’s Hospital were subjected to concurrent TACE+microwave ablation treatment.First,a hepaticartery catheter was inserted,then an ablation needle was inserted under the guidance of ultrasound,and hepatic ar-teriography was performed to confirm the lesion.After microwave ablation treatment,angiography was performedagain to evaluate the lesion.Finally,TACE was used for target artery embolization of the tumor.Follow-ups wereperformed at 1,3,and 6 months.AFP,hepatic artery status,and enhanced ultrasound,CT or MRI examination re-sults were followed up.Meanwhile,complete necrosis rate of tumor,partial necrosis rate of lesion,and recurrencerate of lesion were evaluated to assess the efficacy.Results:Twenty-six lesions in 24 patients with liver cancer wereenrolled in the study;concurrent TACE+ablation treatment was performed 24 times.The response rate was 100%,the complete necrosis rate of lesion was 66.7%,the decrease rate of AFP(as compared with before)was 100%,andthe reoperation rate at three months after operation was 33.3%.The incidence of pain and post-microwave operationsyndromes/embolism syndromes such as nausea,vomiting,and abdominal pain improved after symptomatic treat-ment,and the liver function and routine blood test results mostly returned to normal at the reexamination one weekafter operation.Conclusion:Concurrent TACE and microwave ablation treatment is effective in treating malignantliver tumor.It can improve single-treatment efficacy and reduce the pain of patients with controllable adverse reac-tions.

关 键 词：肝癌 TACE+微波消融同步 临床疗效 

分 类 号：R730.55[医药卫生—肿瘤] R735.7[医药卫生—临床医学]