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目的 :评价经皮微波凝固治疗 (PMCT)恶性肝肿瘤的近期疗效 ,探讨其最佳适应证和治疗相关因素。方法 :应用MTC 3 5 0 0s型微波治疗仪 ,超声或CT引导下经皮穿刺热凝固 ,对 44例肝肿瘤 ( 5 2个结节 ,直径 2 .3～ 8.6cm)进行了116次、3 2 3个点的治疗。每个点微波输出功率 40～ 60W ,作用时间 3～ 6min。分别观察肿瘤坏死范围、大小变化、AFP/CEA水平、肝功能变化及并发症。结果 :治疗后增强CT或MRI示肿瘤区完全无强化占 69.2 % ( 3 6/5 2 ) ,其中直径≤ 5cm3 4个 ;67.3 % ( 3 5 /5 2 )的病灶明显缩小 ;3 2例 ( 3 2 /3 6)原发性肝癌AFP升高者 ,2 8例明显下降 ,且 8例降至正常 ;8例转移癌术前CEA均升高 ,术后明显下降。所有患者术后肝功能轻度损害 ,发生自限性腹腔出血 3例 ,少量反应性胸水 5例、腹水6例均经内科治疗恢复。结论 :初步结果表明 ,PMCT是一种安全有效的治疗方法 ,对于直径 5cm以下的肝肿瘤多可完全灭活 ,对于直径 5cm以上者采用分次治疗可使肿瘤明显缩小
Objective: To evaluate the short-term effect of percutaneous microwave coagulation therapy (PMCT) on malignant liver neoplasm and to explore the best indications and treatment-related factors. Methods: Forty-four hepatic tumors (52 nodules, diameter 2.3-8.6cm) were treated with MTC 3500s microwave-assisted thermal instrumentation guided by ultrasound or CT, 116 times, 3 2 3 points of treatment. Each point of microwave output power 40 ~ 60W, the role of time 3 ~ 6min. The extent of tumor necrosis, changes in size, AFP / CEA levels, changes in liver function and complications were observed. Results: There were 69.2% (36.5%) with no enhancement in the tumor area after enhancement of CT or MRI, 4 of which were ≤ 5cm3 in diameter, 67.3% (35/52) 3 2/3 6) 28 cases of elevated AFP in primary liver cancer decreased significantly, and 8 cases decreased to normal; 8 cases of metastatic carcinoma before CEA were increased, postoperatively decreased significantly. All patients suffered mild damage to liver function, self-limiting intra-abdominal hemorrhage occurred in 3 cases, a small amount of reactive pleural effusion in 5 cases, ascites in 6 cases were recovered by medical treatment. Conclusion: The preliminary results show that PMCT is a safe and effective treatment for liver tumors less than 5cm in diameter can be completely inactivated, for the diameter of more than 5cm with fractionated treatment can significantly reduce the tumor