Emprint^TM微波消融系统在肝细胞癌治疗中的安全性及疗效  

Safety and clinical efficacy of EmprintTM microwave ablation system for hepatocellular carcinoma

作　　者：张小丹 叶火林 苏雅婷 曾庆劲[1] 贺需旗[1] 李凯[1] 郑荣琴[1] 许尔蛟[2] Zhang Xiaodan;Ye Huolin;Su Yating;Zeng Qingjin;He Xuqi;Li Kai;Zheng Rongqin;Xu Erjiao(Department of Ultrasound,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Medical Ultrasonics,the Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen 518033,China)

机构地区：[1]中山大学附属第三医院超声科,广州510630 [2]中山大学附属第八医院超声医学科,深圳518033

出　　处：《中华肝脏外科手术学电子杂志》2020年第6期582-586,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家重点研发计划(2017YFC0112000);国家自然科学基金重点项目(81430038);国家自然科学基金(81401434);广东省科技计划项目(2017A020215082,2017A020215137);广州市科技计划项目(201704020164);中山大学青年教师培育项目(20ykpy37);深圳市福田区卫生公益性科研项目(FTWS2020022)。

摘　　要：目的探讨具有臻圆^TM技术的Emprint^TM微波消融系统在肝细胞癌(肝癌)治疗中的安全性及疗效。方法回顾性分析2019年1月至2019年5月在中山大学附属第三医院诊治的24例肝癌患者临床资料。其中男18例,女6例;平均年龄(52±11)岁。患者均签署知情同意书,符合医学伦理学规定。采用Emprint^TM微波消融系统行微波消融治疗,消融功率100 W。根据第一针消融时间不同分为5 min组和10 min组,术中即时超声造影(CEUS)评估第一针消融范围,观察术后1个月完全消融率及消融相关主要并发症发生率。两组第一针消融范围比较采用t检验。结果24例患者共27个病灶在实时超声引导下Emprint^TM微波消融系统消融,其中5 min组11个病灶和10 min组16个病灶。病灶消融次数中位数2(1~7)次,消融总时间为10(5~45)min。5 min组消融灶长径为(29.3±2.6)mm,明显小于10 min组的(33.7±6.7)mm(t=-2.389,P<0.05);而两组横径、圆度指数和消融灶面积相应为(25.8±3.0)mm、0.88±0.10、(2384±406)mm2和(27.0±6.3)mm、0.81±0.14、(2939±1091)mm2,差异无统计学意义(t=-0.657,1.518,-1.857;P>0.05)。术后1个月复查增强CT或MRI显示,除2例未返院进行复查,余25个病灶均完全消融,完全消融率为100%;复查患者均未发现消融相关主要并发症。结论Emprint^TM微波消融系统用于肝癌治疗安全、有效。在100 W功率下,5 min消融时间可能较10 min更能获得接近于规则、可预测的球形消融范围。Objective To evaluate the safety and clinical efficacy of Emprint^TM microwave ablation system with Thermosphere^TM technology in the treatment of hepatocellular carcinoma(HCC).Methods Clinical data of 24 HCC patients admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to May 2019 were retrospectively analyzed.Among them,18 patients were male and 6 female,aged(52±11)years on average.The informed consents of all patients were obtained and the local ethical committee approval was received.The microwave ablation was performed with Emprint^TM microwave ablation system with an ablation power of 100 W.According to different ablation time of the first insertion,all lesions were divided into the 5-min and 10-min groups.The ablation range of first insertion was assessed by intraoperative contrast-enhanced ultrasound(CEUS).Complete ablation rate and the incidence of major complications induced by ablation were observed at postoperative 1 month.The ablation range of first insertion was compared between two groups by t test.Results 27 lesions from 24 patients were ablated with realtime ultrasound-guided Emprint^TM microwave ablation system,including 11 lesions in the 5-min group and 16 lesions in the 10-min group.The median ablation frequency was 2(1-7)times,and the total ablation time was 10(5-45)min.In the 5-min group,the maximal diameter of ablated lesions was(29.3±2.6)mm,significantly shorter than(33.7±6.7)mm in the 10-min group(t=-2.389,P<0.05).The transverse diameter,round index and ablation area in the 5-min group were(25.8±3.0)mm,0.88±0.10,(2384±406)mm2,which did not significantly differ from(27.0±6.3)mm,0.81±0.14 and(2939±1091)mm2 in the 10-min group(t=-0.657,1.518,-1.857;P>0.05).Enhanced CT scan or MRI at postoperative 1 month showed that 25 lesions were completely ablated with a complete ablation rate of 100%except 2 cases who did not receive reexamination.Reexamination revealed no major complications related to ablation.Conclusions Emprint^TM microwave ablation system is

关 键 词：癌 肝细胞 微波消融 圆度指数 

分 类 号：R735.7[医药卫生—肿瘤]