超声引导下肝脏肿瘤消融治疗的现状与思考  

Current Status and Challenges of Ultrasound-Guided Ablation Therapy for Liver Cancer

作　　者：周燕[1,2] 丁建民 王彦冬[1,2] 经翔 ZHOU Yan;DING Jianmin;WANG Yandong;JING Xiang(Department of Ultrasound,The Third Central Hospital of Tianjin,Tianjin 300170,China;Tianjin Institute of Hepatobiliary Disease,Artificial Cell Engineering Technology Research Center,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院超声科,天津300170 [2]天津市肝胆疾病研究所,天津市人工细胞工程技术研究中心,天津市重症疾病体外生命支持实验室,天津300170

出　　处：《肿瘤防治研究》2025年第4期274-280,共7页Cancer Research on Prevention and Treatment

基　　金：国家自然科学基金(82371986)。

摘　　要：超声(US)引导下肝脏肿瘤局部消融治疗以其微创、疗效确切、并发症少以及可重复的突出优势在临床中获得广泛应用。从最初的无水乙醇消融到以射频消融和微波消融为代表的热消融治疗,再到新兴的不可逆电穿孔治疗;从常规US引导到超声造影及融合影像引导和评估;从单一治疗方式到辅助方法及联合治疗策略的应用;从早期小肝癌到中-大肝癌的治疗探索。US引导下消融治疗在技术本身、影像引导方法、辅助策略以及治疗理念等方面始终处于不断更新和发展中,已从初兴的快速发展时期过渡到成熟阶段并进一步完善。本文将通过对US引导下肝脏肿瘤消融治疗的技术设备、治疗流程、疗效及并发症的现状以及面临的挑战进行概述,以期为介入超声医师提供思考。Ultrasound-guided local ablation therapy for liver tumors has extensive clinical application because of its minimal invasiveness,proven effectiveness,low complication rates,and suitability for repeat treatments.Ultrasound-guided interventional therapy has continuously evolved in terms of the following:technological advancements,from the initial utilization of percutaneous ethanol injection to thermal ablation therapies exemplified by radiofrequency ablation and microwave ablation and presently advancing toward emerging techniques such as irreversible electroporation;imaging methods,from conventional ultrasound guidance to contrast-enhanced ultrasound and fusion imaging for precise guidance and assessment;supplementary strategies,from monotherapy to auxiliary method and synergistic therapy;and innovative treatment concepts,from early-stage small hepatocellular carcinoma to intermediate and even large liver cancers.The development of ultrasound-guided local ablation of liver cancers has progressed from an initial phase of rapid advancement to a mature stage characterized by further enhancements.This article provides a comprehensive overview of the status of technical equipment,treatment processes,efficacy,complications,and challenges encountered in ultrasound-guided local ablation for liver tumors,with the objective of offering valuable insights for interventional ultrasound physicians.

关 键 词：局部消融 微波消融 射频消融 肝癌 超声介入 

分 类 号：R730.56[医药卫生—肿瘤]