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目的评价经肝动脉化疗栓塞-冷循环微波刀序贯治疗对肝癌的安全性和有效性。方法60例肝癌患者接受治疗,瘤块体积均大于5cm。其中仅27例瘤块为单个,其余33例为多个,但均不超过6个。所有病例均经过全面评价,均失去最佳手术切除时机。化疗栓塞采用经皮经肝动脉插管,1周后常规复查CT观察碘油沉积情况,如果肿瘤被栓塞不完全充分,则予冷循环微波刀治疗。结果中位随访期12个月(6～18个月),CT随访显示,128个肿瘤结节中,108个病灶(占84.3%)为完全坏死,16个病灶(占12.76%)为不完全坏死,4个(3.1%)病灶为部分坏死。其中44个原发癌灶中36完全坏死(占80.3%),16个转移癌灶中12个完全坏死(占75%)。结论经肝动脉化疗栓塞-冷循环微波刀序贯治疗肝癌效果良好,能明显使肿瘤缩小甚至消失,是一种微创、有效的治疗方法。
Objective To evaluate the safety and efficacy of sequential treatment of hepatic artery by hepatic artery chemoembolization and cold cycle microwave knife. Methods Sixty patients with hepatocellular carcinoma were treated, and the tumor masses were all larger than 5 cm. Of these, only 27 had a single tumor, and the remaining 33 were multiple, none of which exceeded 6. All cases were fully evaluated, all lost the best time for surgical resection. Chemotherapy embolization percutaneous transhepatic arterial catheterization, 1 week after routine review of CT observation of lipiodol deposition, if the tumor is not fully embolized, then to the microwave cycle microwave knife treatment. Results The median follow-up period was 12 months (range, 6 to 18 months). CT follow-up showed that of the 128 tumor nodules, 108 lesions (84.3%) were completely necrotic and 16 lesions (12.76%) were incomplete Necrosis, 4 (3.1%) lesions were partially necrotic. Of the 44 primary tumors, 36 were completely necrotic (80.3%) and 12 of 16 metastatic lesions were completely necrotic (75%). Conclusions Transcatheter arterial chemoembolization - cold cycle microwave knife sequential treatment of liver cancer with good results, can significantly reduce or even disappear the tumor, is a minimally invasive and effective treatment.