低杆温微波刀与冷循环射频消融在肝肿瘤治疗中的临床应用

目的探讨低杆温微波刀（cool-needle microwave coagulation treatment，MCT）与冷循环射频消融（cool-tipradiofrequency ablation，RFA）在恶性肝肿瘤治疗中的临床应用价值。方法超声引导下冷循环射频消融治疗原发性肝癌患者20例共22个病灶，而经超声引导下低杆温微波刀治疗原发性肝癌和肝转移癌19例共21个病灶，治疗前后经超声造影、增强CT或／和增强MRI检查明确诊断及评价疗效。结果22个病灶经一次RFA治疗后完全消融16个，5例经再次RFA后达完全消融；21个病灶经一次MCT治疗后16个达完全消融，4例经再次MCT治疗后达完全消融。两者一次完全消融率分别为72．7％（RFA）和76．2％（MCT），差异无统计学意义。结论低杆温MCT和冷循环RFA均能有效地原位灭活肝肿瘤，是有效的非手术治疗恶性肝肿瘤的方法之一。

Cool-needle Microwave Coagulation Treatment and Cool-tip Radiofrequency Ablation in Treatment of Malignant Hepatic Tumors

Objective To assess the effectiveness of cool-needle microwave coagulation treatment(MCT)and cool-tip radiofrequency ablation(RFA)in treating malignant hepatic tumors.Methods Twenty patients with 22 hepatocellular carcinomas(HCC)were treated with ultrasound-guided cool-tip RFA.Nineteen patients with 21 malignant hepatic tumors(17 HCC,3 metastatic tumors and one cholangiocellular carcinoma)were treated with cool-needle MCT.Contrast-enhanced ultrasound,contrast-enhanced CT and/or contrast-enhanced MRI were performed before and after the treatments for differential diagnosis and assessment of the therapeutic effect.Results Of 22 HCC nodules treated with RFA,16(72.7%,16/22)were completely ablated after one procedure.The other four approached to complete necrosis after the second RFA procedure.Of 21 tumors treated with MCT,16(76.2%,16/21)were completely coagulated after one procedure.After another procedure of MCT,2 were completely treated,One patient was treated incompletely and the another one was found recurrent focus in the liver.There was no signficant difference of the effectiveness between MCT and RFA in treating malignant hepatic tumors.Conclusions Like cool-tip RFA,cool-needle MCT is another adaptive method for malignant hepatic tumor.