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作 者:刘国涛 朱正[1] 倪庆丰[1] 沈波 吴晓曼 张宇航 周超 董学明[1] 王文平 李卫平[1] LIU Guotao;ZHU Zheng;NI Qingfeng;SHEN Bo;WU Xiaoman;ZHANG Yuhang;ZHOU Chao;DONG Xueming;WANG Wenping;LI Weiping(Department of Ultrasound,Taicang First People's Hospital,Taicang 215400,Jiangsu Province;Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
机构地区:[1]太仓市第一人民医院超声科,江苏太仓215400 [2]复旦大学附属中山医院超声科,上海200032
出 处:《肿瘤影像学》2020年第5期495-499,共5页Oncoradiology
摘 要:目的:评估超声引导下经皮经肝微波消融治疗肝癌的治疗效果及安全性。方法:回顾并分析2015年4月—2020年1月江苏省太仓市第一人民医院采用超声引导下行微波消融术治疗的35例(共49个病灶)原发性或转移性肝癌患者,术后定期随访超声造影及肝功能指标丙氨酸氨基转移酶(ALT)评价治疗效果以及肝脏损伤情况;以及观察并发症发生情况。结果:术后即时超声造影显示所有病灶均完全灭活。术后超声造影随访结果:3个月肝内未见复发;6个月原肿瘤消融部位复发2例;至9及12个月原肿瘤消融部位复发仍为2例,无新增复发患者。术后1周ALT较术前明显上升(P<0.05),术后1及3个月复查ALT均降至术前相仿水平(P>0.05)。消融术并发症:术中1例因疼痛致手术暂停,休息5 min缓解后继续手术;术后切口或右上腹轻度不适15例;术后1周内发热23例;术后胸腔少量积液3例;术后腹腔出血1例。结论:采用超声引导下经皮经肝微波消融技术治疗肝癌是安全可行的,可取得比较满意的治疗效果,值得临床推广使用。To evaluate the efficacy and safety of ultrasound-guided percutaneous transhepatic microwave ablation in the treatment of liver cancer.Methods:Retrospective analysis of 35 cases(49 lesions)of primary or metastatic liver cancer treated by ultrasound-guided microwave ablation in Taicang First People's Hospital from Apr.2015 to Jan.2020,regular postoperative follow-up of contrast-enhanced ultrasonography(CEUS)and hepatic function(ALT)were performed to evaluate the therapeutic effect and liver injury,and to observe the complications.Results:All the lesions were completely inactivated by CEUS after operation.The results of follow-up showed that there was no recurrence in the liver at 3 months.There were 2 cases with recurrence of the original ablation site at 6 months,and no new cases at 9 months and 12 months.ALT increased significantly at 1 week after operation(P<0.05),and decreased to the same level at 1 month and 3 months after operation(P>0.05).The complications of ablation included 1 case was stopped during operation due to pain,rest for 5 min;15 cases had slight discomfort in incision or right upper abdomen;23 cases had fever within 1 week after operation;3 cases had small pleural effusion after operation;1 case of postoperative abdominal hemorrhage.Conclusion:Ultrasound-guided percutaneous microwave ablation is a safe and effective method for the treatment of liver cancer.It is worthy of clinical application.
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