超声引导微波凝固治疗肝癌的临床疗效观察

目的：观察超声引导微波凝固治疗肝癌的疗效及对肝功能和免疫功能的影响。方法：在超声引导下经皮穿刺植入单极或双极微波天线对肝肿瘤进行整体覆盖原位热凝固灭活治疗，分别于治疗前1w及治疗后2w复查CT、甲胎蛋白(AFP)及超声，检验肝功能、免疫球蛋白、NK细胞、T淋巴细胞及亚群等指标并作比较。结果：20例肝癌患者(45个瘤结节)治疗后2w超声显示，瘤体均缩小，均呈低回声。增强GT显示瘤体内血流信号消失(44／45)。12例原发性肝癌中10例AFP升高患者中有8例降至正常，2例明显下降。治疗前后肝功能变化不明显，CD4/CD8明显升高，NK细胞明显上升，免疫球蛋白含量变化不明显。2年内随访20例患者死亡1例。结论：超声引导经皮穿刺微波凝固治疗肝癌效果确切，可提高机体免疫功能。

Clinical assessment of sonographically guided microwave coagulation therapy in patients with liver carcinoma

Objective: To assess the effect of sonographically guided percutaneous microwave coagulatio n therapy (PMCT) on liver carcinoma and to observe the changes of liver function and immune function. Methods:20 patients with liver carcinoma (45 nodules) underwent sonographically guided PMCT by planted single electrode or double electrodes. T he curative effect was assessed by enhanced-CT, US, AFP, liver function, immune globins, CD3, CD4, CD8, NK cells et al in 1 week before and 2 weeks after treat ment. Results:The tumor size was decreased with lower echo after 2 weeks of treatment. No blood signal was identified in 44 nodoules on dyn ami c enhancement CT. Of the 12 primary hepatic carcinoma patients with AFP level el evation, AFP turned from positive to negative in 8 cases, 2 cases decreased obvi ously. Before and after the treatment, the liver functions and immunglobu lins had no evident changes, but C D 4/CD 8 and NK cells increased significantly. Within 2 years follow-up, only 1 patient died. Conclusion:Effect of PMCT is assured and can enhan ce the cellular immune functon of patients.