【摘要】 目的:探讨经皮水冷式微波固化单针消融系统治疗毗邻胆囊、胃肠道、肝内主要血管、膈肌的特殊部位肝肿瘤的安全性与疗效。方法:从2009年7月至2011年6月,33例特殊部位肝肿瘤患者(肿瘤最大径≤5 cm且肿瘤数目≤3,毗邻部位:胆囊8例,胃肠道9例,门静脉右支11例,下腔静脉1例,膈肌4例)接受经皮水冷式微波固化术,探讨其安全性、并发症、固化范围及其疗效。结果:33例患者共42个肿瘤[肿瘤直径介于2.1～4.6 cm,平均直径为(3.4±0.9)cm]接受微波水冷式微波固化术,围术期无严重并发症,3例患者出现右侧胸腔积液;水冷式微波固化范围为(4.8±1.1)cm(固化范围介于3.5～6.0cm),共41个肿瘤取得完全消融,完全消融率为97.6%;1例毗邻横结肠肿瘤固化不完全经补充治疗后取得完全固化。结论:水冷式微波固化单针消融系统治疗特殊部位肝肿瘤是安全的,能产生较大固化范围,对于直径≤5cm肝肿瘤基本能达到完全固化的目的,是安全的微创治疗手段。更多还原

【Abstract】 Objective:To determine the safety and efficacy of percutaneous single cool-tip microwave coagulation svstem for the treatment of specially located liver malignant tumors,namely,those adjacent to gall bladder,gastrointestinal tract,major intrahepatic blood vessels or the diaphragm.Methods:Thirty-three consecutive patients with specially located liver malignant tumors[maximal diameter≤5 cm,number of tumors≤3;adjacent organs:gall bladder(n = 8),gastrointestinal tract(n =9),right portal vein(n = 11 ),inferior vena cava(n = 1 ) and diaphragm(n =4)]were treated with percutaneous single cool-tip microwave coagulation between July 2009 and June 2011.The safety,complication,area of coagulation and efficacy were assessed. Results:A total of 42 tumors[mean diameter:(3.4±0.9 ) cm,range:(2.1～4.6) cm]in 33 patients were treated with percutaneous single cool-tip microwave coagulation.No serious complication was reported during the perioperative period.3 patients were revealed as having pleural effusion.The zone of cool-tip microwave coagulation was(4.8±1.1 ) cm[range:(3.5～6.0) cm].41 tumors(97.6%) achieved complete ablation. Additionally,incomplete coagulation was complemented in a patient with adjacent transverse colon cancer. Conclusion:Percutaneous single cool-tip microwave coagulation system is a safe measure for specially located liver malignant tumor.Complete coagulation can be achieved for the tumors with diameter≤5 cm and may be regarded as a safe minimally invasive treatment owing to the extensive impact.更多还原