摘要
目的 改进微波消融技术治疗肝癌 ,评价近期临床效果。方法 自 2 0 0 3年 8月至 2 0 0 4年 7月 ,利用低杆温微波电极在经皮肝癌消融治疗中无皮肤腹壁组织烧伤之虞的优点 ,改进常规的消融方法 ,将单次能量输出增加至 (70～ 80 )W× (2 0～ 2 5 )min ,对直径 >5cm的结节插入 3～ 4针 ,每个病灶治疗 1次。该研究运用该技术在超声引导下经皮消融治疗了 6 6例肝癌病人 10 5个肿瘤结节 ,观察组织消融范围、肿瘤完全消融率、局部复发率和并发症发生率。结果 增强CT或MRI扫描显示单次能量输出造成的组织消融范围可达到 (3 5～ 4 0 )cm×(4 5～ 5 0 )cm。肿瘤经 1次治疗的完全消融率为 92 4 % (97/ 10 5 )。直径≤ 3cm、>3cm和 >5cm结节的完全消融率分别为 94 0 (6 3/ 6 7)、88 9% (2 4 / 2 7)和 90 9% (10 / 11) ,3组间以及每两组间差异无显著性 (P值均大于0 0 5 )。在 1 0～ 12 4个月随访期间内 3个病灶 (2 9% )局部复发。无与治疗相关的死亡 ,并发症发生率 15 2 %(10 / 6 6 )。结论 改良的微波消融技术安全、有效 ,通过增加单次能量输出能够扩大组织消融范围 ,提高局部疗效 ,减少治疗次数和穿刺针数 ,降低治疗成本。
Objective To evaluate a short-term therapeutic efficacy in treating liver cancer by using an innovated technique of microwave ablation. Methods Technique of percutaneous microwave ablation for treating liver cancer was improved by using a novel electrode with low-temperature shaft, which does not cause burning of abdominal wall during the treatment. The single energy output was increased to (70～80)W×(20～25)min, 3～4 electrode insertions was applied for nodule with diameter >5cm and one treatment session was applied for each lesion. Sixty-six patients with 105 liver cancer nodules were treated with this technique under ultrasound guidance. The ablated area, complete ablation rate, local recurrence and complication were evaluated. Results The ablated area of (3.5～4.0)cm×(4.5～5.0)cm by using single energy output was observed on contrast-enhanced CT or MRI. The complete ablation rate after one treatment session was 92.4% (97/105). For nodules with diameter ≤3cm, >3cm and >5cm, the complete ablation rates were 94.0%(63/67), 88.9%(24/27) and 90.9%(10/11), respectively. There were no significant differences among three groups and between every two groups (all P>0.05). During a follow-up period of 1.0～12.4 months, local recurrence was presented in 3(2.9%) nodules. There was no treatment related death, and the complication rate was 15.2% (10/66).Conclusion The innovated technique of microwave ablation is safe and effective, which can improve local therapeutic efficacy by increasing single energy output to enlarge ablated area and reduce cost by decreasing the number of treatment session and electrode insertion.
出处
《中国实用外科杂志》
CSCD
北大核心
2004年第11期678-680,i006,共4页
Chinese Journal of Practical Surgery
关键词
微波消融
治疗
肝癌
超声引导
Liver cancer Microwave ablation Ultrasound guidance
