超声引导下新型内冷微波天线消融治疗肝癌临床研究

摘要

目的 比较新型内冷天线与非内冷天线微波消融治疗肝癌的临床效果.方法 在超声引导下,应用新型内冷天线对43例肝细胞癌患者进行微波消融治疗,将术中与术后的并发症、1月后消融灶的残癌率、1年内消融灶的原位复发率及1年后肝内肝细胞癌总的复发率等指标与以往应用非内冷微波天线消融治疗的17例肝细胞癌患者的相应结果进行比较分析.结果 与非内冷天线比较,新型内冷天线治疗患者疼痛发生率从90.9％下降到38.5％,无拔针困难和皮肤烫伤并发症,术后出血并发症也明显减少,两组比较,有显著统计学差异(P＜0.05)；影像学检查表明,新型内冷天线的微波消融灶较非内冷天线者球体性好,R值更接近1(P＜0.01)；新型内冷天线治疗后1月的残癌率(1.9％)及1年内消融部位的原位复发率(5.8％)显著较非内冷天线者(分别为13.6％和22.7％)减低(P＜0.05),而两组术后一年期肝内肝细胞癌总的复发率无显著性差别(P＞0.05).结论 与非内冷天线治疗比,新型内冷天线能有效降低肝癌经皮微波消融治疗的术中、术后并发症和原位复发率,更适合肝癌的微波消融治疗.%Objective To compare the clinical effects of two different microwave antennas in the treatment of patients with hepatocellular carcinomas (HCCs). Methods Under the guidance of ultrasonography,forty-three patients with HCC were ahlated using the internally-cooled microwave antenna,and 17 patients with HCC were ablated using the non-internally cooded antenna. The therapeutic effects of the two antennas were compared. Results During therapeutic period,the complications(including local pain,the difficulty of drawing out the antenna, bleeding and skin burning) in the internally cooled antenna were fewer than those in the non-internally cooled antenna (P<0.05);The coagulation necrosis by the internally-cooled antenna took a more round shape (P<0.01), and the rate of carcinoma-remained in the ablation sites and 12-month recurrence in ablation by internally cooled antenna were obviously lower than in the non-internally cooled antenna (P<0.05), while the rate of 12-month recurrence in liver in the two groups had no significant difference (P>0.05). Conclusions Compared with the non-internally cooled microwave antenna,the internally cooled antenna boasts less complications and lower local recurrence for microwave ablation of HCCs.