【摘要】 目的:探讨微波消融(MWA)治疗肝脏恶性肿瘤的临床疗效及并发症分析。方法:208例肝脏恶性肿瘤患者接受了241例次的MWA。肝细胞肝癌(HCC)171例行198例次的MWA,肿瘤总数301个,平均1.5个,肿瘤平均最大直径(2.9±1.3)em,其中57例接受了肝切除联合MWA;肝转移癌(MLC)37例行43例次的MWA,肿瘤总数67个,平均1.6个,肿瘤平均最大直径(2.6±1.5)cm。全组病例的治疗通过经皮和开腹两种途径,治疗后定期进行影像学和肿瘤标志物检查。结果:MWA 1个月后行增强CT检查,HCC 301个肿瘤中285个完全消融,完全消融率为94.7%(285/301),MLC 67个肿瘤中62个完全消融,完全消融率为92.5%(62/67)。随访3～43个月,HCC局部复发率为8.4%(24/285),1、2、3年生存率分别为89.0%、74.2%、53.6%,其中肝切除联合MWA治疗的患者1、2、3年生存率分别为81.3%、66.4%、46.7%;MLC局部复发率为9.7%(6/62),中位生存期17～23个月。HCC患者MWA的严重并发症发生率为2.5%(5/198),MLC患者的治疗未出现严重并发症。结论:MWA治疗肝脏恶性肿瘤创伤小,安全有效,具有重要的临床价值。更多还原

【Abstract】 Objective:This study aims to explore the treatment effect and relevant complications of microwave ablation(MWA) therapy on malignant liver tumors.Methods:MWA was conducted in 208 liver tumor patients(241 surgical procedures).Among the total number of cases,MWA was conducted in 171 hepatocellular carcinoma(HCC)patients suffering from 301 tumors(average,1.5 tumors;198 procedures).The largest tumor diameter was 2.9±1.3 cm.Among the 171 HCC patients,57 were subjected to MWA combined with hepatectomy.MWA was conducted in 37 metastatic liver cancer(MLC)cases suffering from 67 tumors(average,1.6 tumors; 43 procedures).The largest tumor diameter was 2.6-1.5 cm.All patients were treated with MWA via percutaneous or open surgery. Results:Contrast-enhanced computed tomography was performed 1 month after MWA.The complete ablation rate for HCC and MLC was 94.7%(285/301)and 92.5%(62/67),respectively.The patients were followed-up for 3 months to 43 months.The local recurrence rate of tumors was 8.4%(24/285),and the one-,two-,and three-year survival rates were 89.0%,74.2%,and 53.6%,respectively. The one-,two-,and three-year survival rates of the patients who underwent MWA plus hepatectomy were 81.3%,66.4%,and 46.7%,respectively.The local recurrence rate of tumors was 9.7%(6/67),and the median survival time for the MLC patients ranged between 17 and 23 months.The rate of severe complications for the HCC patients undergoing MWA was 2.5%(5/198).Severe complications did not occur in the MLC patients.Conclusion:Treating malignant liver tumors through MWA is safe,effective,and less invasive. The clinical value is significant.更多还原