减少微波消融治疗特殊部位肝肿瘤并发症的方法分析

目的：探讨特殊部位肝肿瘤在经皮超声下微波消融治疗中发生并发症的原因及防治措施，以期降低其发生率。 方法：回顾性分析2011年2月—2016年3月收治的特殊部位肝肿瘤患者74例，其中原发性肝癌45例，肝血管瘤13例，肝转移癌16例。采用经皮超声下微波消融进行治疗，观察其并发症发生情况并分析其原因。 结果：74例特殊部位肝肿瘤消融术后发生膈肌损伤并膈疝1例，胸腔积液4例，结肠穿孔并腹膜炎1例，胆漏2例，消融术中出现心率减慢1例。肝包膜下血肿7例。 结论：特殊部位肝肿瘤经皮超声下微波消融难度大，并发症发生率高，需提前做好预防及处理。灵活运用多种手段规避风险，减少并发症。

Methods for reducing complications of microwave ablation for certain liver tumors

Objective:To investigate the complications caused by microwave ablation in the treatment of certain liver tumor and how to lower the occurrence of such complications during the treatment. Methods:A retrospective analysis of 74 cases with special parts liver tumors admitted and treated with percutaneous ultrasound MWA in our hospital and Binzhou Medical College Hospital during February 2011—March 2016 was conducted. Among these 74 patients, 45 had primary liver cancer, 13 liver hemangioma, and 16 metastatic liver cancer. Results:Among the 74 patients after microwave ablation, 1 developed diaphragmatic injury and hernia, 4 had pleural effusion, 1 colonic perforation and peritonitis, 2 bile leakage, 1 slow heart rate, and 7 developed hepatic subcapsular hematoma. Conclusions:The percutaneous microwave ablation ultrasound could cuase a high incidence of complications in treating special parts of the liver cancer. thus, more preventive measures should be adopted before the procedure. Flexible use of various means to avoid risks andreduce complications is suggested.