超声引导下近胆囊旁肝癌的微波消融治疗分析

目的分析超声引导下应用微波消融治疗近胆囊旁肝癌的效果及临床价值。方法选择2009年1月至2012年12月于就诊本科室的近胆囊旁肝癌患者65例为观察组,病灶共65个,选择同期位于肝实质内的肝癌患者50例为对照组,病灶共55个。均行超声引导下微波消融术治疗,统计消融结果。持续随访3~24个月,观察肿瘤的灭活情况及术后并发症。结果两组消融效果均较好,一次消融成功率、辐射时间等均无显著性差异（P ＞0.05）。观察组术后复查,4个病灶局部肿瘤进展,其发生率6.15%（4/65）,疗后3个月,肿瘤完全坏死率89.2%（58/65）；对照组局部肿瘤进展发生率9.09%（5/55）,肿瘤完全坏死率94.5%（52/55）,两组对比,差异无统计学意义（P ＞0.05）。随访期间所有患者均未出现明显并发症,仅部分患者出现发热、腹痛等症状,未经特殊处理,自然消退,其中观察组并发症发生率69.23%（45/65）,对照组发生率76.00%（38/50）,组间差异亦无统计学意义（P＜ 0.05）。结论超声引导微波消融术治疗近胆囊旁肝癌疗效确切,安全性高,具备临床推广价值。

Analysis of Ultrasound-guided Microwave Ablation for the Treatment of Liver Cancer near to Gallbladder

Obj ective]To analyze the efficacy and clinical value of ultrasound-guided microwave ablation for liver cancer near to gallbladder.Methods]A total of 6 5 patients（6 5 lesions）with liver cancer near to gall-bladder in our department from Jan.2009 to Dec.2012 were chosen.Other 50 patients（55 lesions）with liver parenchyma cancer during the same period were chosen as control group.All patients underwent microwave ablation guided by ultrasound.The result of ablation was calculated.All patients were continuously followed up for 3~24 months.The ablation of tumor and postoperative complications were observed.Results]The ablation effect of two groups was good.There was no significant difference in one-time success rate of ablation and radiation time between two groups（P 〉0.05）.Postoperative reexamination of observation group showed that 4 lesions（6.15%,4/65）were local tumor progression,and the complete tumor necrosis rate at 3 months after treatment was 89.2%（58/65）.The rate of local tumor progression in control group was 9.09%（5/55）, and the complete tumor necrosis rate was 94.5%（52/55）.There was no significant difference in local tumor progression rate and complete tumor necrosis rate between two groups（P 〉0.05）.During the follow-up,no obvious complication occurred in all patients.Only some patients had symptoms such as fever,abdominal pain and so on,and were spontaneous regression without special treatment.The incidence rates of complications in observation group and control group were 69.23%（45/65）and 76.0%（38/50）respectively,but there was no significant difference between two groups（P〈 0.05）.Conclusion]Ultrasound-guided microwave ablation for the treatment of liver cancer near to gallbladder has certain efficacy,high safety and clinical popularization val-ue.