超声引导下微波介入治疗大肝癌的实验研究及临床应用

目的进一步探讨超声引导下微波治疗大肝癌的可行性和疗效。方法采用分次多点多部位由深到浅低功率长时间分段微波凝固，对10个65斤重的猪肝和2只狗进行了实验研究；60例大肝癌患者进行了超声引导下微波治疗。结果微波治疗后两个或多个坏死区叠加，凝固坏死区加大。离体猪肝坏死区达到6cm×6cm，狗肝坏死区为5cm×6cm。所有病例治疗后肿块缩小，肿瘤内血流消失或减少；22例CT检查，肿块缩小，18例无强化；28例超声引导下活检大片坏死。治疗后全身情况好转，AFP和肝功能改善，生活质量提高。无严重并发症发生。随访3～28个月，51例存活。结论实验研究表明改进微波治疗方法，坏死区加大，超声引导微波治疗大肝癌也有较好的疗效。

Experimental Study and Clinical Application of US-guided Microwave in the Treatment of Advanced Liver Cancer

Objective To study the feasibility and therapeutical effect of US-guided percutaneous microwave coagulation therapy for advanced liver cancer. Methods The ultrasound microwave therapy -I(UMC-I) equipment was utilized to treat 60 patients with advanced liver cancer and livers of 10 pigs, by multistage, multipoint and long-time segmental coagulation from interior to superficies, with an output of 30~60W lasting 200~1800s. Results There were 6cm×6cm coagulation necrosis areas in animal liver;51 patitents remained alive with 3~28 months follow up. After the treatment, all lesions (nodules) decreased in size and blood flow in nodules disappeated. Repeated biopsy in 28 patients showed complete tumor necrosis. There was no enhancement in the tumors on enhanced CT scans. AFP dropped. All patients were in a good condition. They showed relief or disappearance of symptom, significant increase in diet, improvment in AFP and liver function, without serious complication. Conclusion US-guided microwave is effctive, safe and practical for the treatment of advanced liver cancer.