超声引导下经皮微波凝固治疗肝癌的临床应用

目的探讨超声引导下经皮微波凝固治疗肝癌的临床应用价值。方法治疗３２例肝癌５７个结节。每个点的凝固治疗采用输出功率６０Ｗ,作用时间２４０～３００秒。５７个结节进行９２次１８２个点的治疗。结果随访５～１８个月,平均１０．４个月,２９例健在,３例死亡。治疗后８５．９％（４９／５７）的肿块缩小,超声显示７８．２％（３６／４６）的肿块内血流消失,增强ＣＴ显示７６．４％（２５／３４）的肿瘤内无强化。原血ＡＦＰ升高１３例,治疗后１１例降至正常。２７例患者全身情况改善,１９例体重增加。１４例治疗后再次活检,１２例肿瘤呈完全性坏死,代之以纤维结缔组织增生。结论超声引导下经皮微波凝固肝肿瘤,在大部分病例可以达到使肿瘤完全性坏死的较好疗效,可望成为肝癌非手术治疗的重要途径。

Clinical application of ultrasound(US)-guided percutaneous microwave coagulation therapy for liver cancer

OBJECTIVE: To evaluate clinical application of US-guided percutaneous microwave coagulation therapy for liver cancer. METHODS: 32 patients with 57 nodules of liver cancer were treated, 57 nodules were coagulated by 92 times at 182 different points. Output of one coagulation was 60 W last mg 240-300 sec. RESULTS: The follow-up period was 5-18 months, averaging 10.4 months. 29 patients remained alive, 3 patients died. After treatment, 85.9%(49/57) of the nodules decreased in size; color blood flow signal disappeared in 78.2(36/46) nodules on color and energy Doppler scans; and there was no enhancement in 76.4%(25/34) tumors on enhanced CT scans. In 13 patients with increased AFP level before therapy, it dropped to normal after treatment in 11 patients. Of 27 patients whoes a good general condition was good, 19 patients gained bodies weight. Repeated biopsy in 14 cases showed complete tumor necrosis with fibrosis in 12. CONCLUSION: US-guided percutaneous microwave coagulation therapy is able to induce total tumor necrosis of liver cancer in most cases. It can be expected as an important non-operative therapy of liver cancer.