经皮微波凝固与根治切除术治疗小肝癌的疗效比较

目的探讨超声引导下微波凝固治疗小肝癌效果。方法原发性肝癌患者共88例,肿瘤单发,且直径均<3cm,其中接受手术治疗58例,接受微波凝固治疗30例。手术采取根治性切除术。微波凝固治疗应用FORSEA MTC-3型微波治疗仪,微波输出功率70W,治疗时间15～20min。比较两组患者并发症发生及1、2、3年生存率。结果微波凝固治疗组并发症发生率明显低于手术组,1、2、3年生存率两组无明显差异。结论对于直径<3cm的小肝癌,尤其是肝功Child-C级、不能耐受手术治疗或肿瘤位于实质内靠近主要血管、胆管切除困难的患者,微波凝固治疗具有与手术相同的疗效,且并发症少。

Clinical contrast research about percutaneous microwave coagulation and radical surgery therapy for small hepatocellular caracinoma

Objective To observe the curative effect of percutaneous microwave coagulation therapy(PMCT) for hepatocellular carcinoma,and compared with traditional surgical operation.Methods The 88 cases with primary liver cancer(single tumor,andΦ <3 cm) were randomized into two groups according to the different therapeutic measures to be taken,58 cases had received traditional surgical operation and 30 cases PMCT,surgical operation way were regular and irregular hepatectomy.PMCT instrument was FORSEA MTC-3,under local or general intravenous anesthesia,a thin percutaneous microwave antenna was introduced under ultrasound guidance into the tumor in the liver for thermo-coagulation;treatment power,70 W;treatment time,15-20 min.The patients were followed-up by means of telephone or letters.Results The complications of PMCT group were lower remarkably than that of traditional surgical operation group,and the life qualities were superior to that of traditional surgical operation group,and there were no difference in the survival rate between two groups within 1,2,3 years.Conclusion PMCT gives the same curative effect as traditional surgical operation on liver tumor with Φ<3 cm,especially PMCT is suitable to these patients whoes liver function is in Child-C stage,and who don't endure surgical operation,or whose tumor is closed to big blood vessel and bile duct,and PMCT's complications are few,the patient's quality of life is good.