摘要
目的探讨B超引导下应用微波消融术治疗特殊部位[指邻近胆囊、膈肌、心脏、肝门部、大血管等(即肿瘤距上述器官最短距离≤0.5cm)]中晚期肝癌的有效性和安全性。方法选择2006年10月至2008年12月外科住院的特殊部位中晚期原发性肝癌患者21例作为治疗组,并通过分层随机选取同期普通部位原发性肝癌患者20例作为对照组,两组患者均接受微波消融术治疗。术前术后均行B超,增强CT或MRI检查,同时检测甲胎蛋白(AFP),并观察不良反应及并发症。结果经微波消融术治疗后1个月,治疗组和对照组肿瘤坏死率分别为90.5%(19/21)、90.0%(18/20);1个月后治疗组和对照组复查AFP,转阴率均为78.6%(11/14);治疗组与对照组6个月、1年、2年、3年生存率分别为:100.0%(21/21)、95.0%(20/21)、81.0%(17/21)、71.4%(15/21)和100.0%(20/20)、95.0%(19/20)、90.0%(18/20)、80.0%(16/20)。结论采用微波消融对特殊部位中晚期肝癌进行治疗确切有效,其疗效与普通部位原发性肝癌疗效接近。
Objective To evaluate the efficacy and safety of percutaneous microwave ablation （PMB） for liver tumor abutting special locations such as gallbladder, diaphragm, heart, hepatic port, great vessels （with the shortest distance of tumor from the organ （〈 0.5 cm） under B ultrasound guidance. Methods Twenty-one patients with advanced liver tumors abutting special locations received PMB were enrolled and served as treatment group. Meanwhile, comparative studies were also performed using controls （20 cases with advanced liver tumors abutting common locations） by stratified random selection. All the patients followed ultrasound （or contrastenhanced ultrasound） and enhanced CT scan or MRI before and after the treatment, and underwent alpha-fetoprotein （AFP） detection. Adverse reactions and complications in the two groups were observed. Results According to the results of the CT scan after 1 month, there were 19 cases with complete tumor necrosis in the treatment group and 18 in the control group, and necrosis rates was 90.5% （19/21） and 90.0% （18/20）, respectively. The negative rates of AFP were all 78.6% （11/14） in the two groups after 1 month treatment. The whole survival rates of years 0.5, 1, 2, 3 were 100.0% （21/21）, 95.2% （20/21）, 81.0% （17/21）, 71.4% （15/ 21） in the treatment group and 100.0% （20/20）, 95.0% （19/20）, 90.0% （18/20）, 80.0% （16/20） in the controls, respectively. Conclusion The efficacy of a proper PMB treatment for the liver tumors adjacent to special locations is closed to that of PMB for common locations.
出处
《中华危重症医学杂志（电子版）》
CAS
2012年第2期6-9,共4页
Chinese Journal of Critical Care Medicine:Electronic Edition
关键词
肝肿瘤
微波
消融技术
特殊部位
Liver neoplasms
Microwaves
Ablation technology
Special location
