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目的 探索扩展经皮微波凝固肝组织范围的有效途径 ,提高较大肝癌的根治率 ,并减少穿刺次数。方法 用自行研制的HM WIA型微波治疗仪对离体新鲜猪肝及活体实验兔、猪肝行微波凝固 ,观察天线长度、微波功率、时间、组织血流对凝固范围及形态的影响。结果 运用改进的单微波电极、中强度微波功率 (4 5～ 5 5W )对离体、活体缺血组织行长时间 (15～ 19min)凝固 ,最大凝固短径分别达 5 .6cm、5 .3cm ,凝固体积达文献的 3倍 ;实验发现天线长 3 6mm时凝固形态最佳 ;活体组织缺血凝固体积为正常供血凝固时的 2 .8倍 (P <0 .0 5 )。结论 采取“缺血后微波凝固策略” ,运用改进的微波电极、中强度微波功率、长时间凝固有效地扩大了凝固范围 ,这将有利于提高肝癌尤其大肝癌的疗效 ,并明显减少穿刺次数。
Objective To explore effective ways to extend the scope of percutaneous microwave coagulation of liver tissue, to improve the cure rate of larger liver cancer and to reduce the number of punctures. Methods The freshly prepared porcine liver and in vivo experimental rabbit and porcine liver were subjected to microwave coagulation with HM WIA microwave therapeutic apparatus. The effects of antenna length, microwave power, time and tissue blood flow on the coagulation scope and morphology were observed. Results With the improved single-microwave electrode, the medium-intensity microwave power (45-55W) was used to coagulate the isolated and living ischemic tissues for a long time (15-19min), the maximum short-path of coagulation was 5.6cm and 5.3cm , The volume of solidification up to 3 times the literature; experiment found that the antenna length of 36mm when the best coagulation morphology; live tissue volume of coagulation is 2.8 times the normal blood supply coagulation (P <0. Conclusion Taking the strategy of “microwave coagulation after ischemia”, using the improved microwave electrode, medium-intensity microwave power and long-term coagulation effectively expand the range of coagulation, which will help to improve the curative effect of liver cancer, especially large hepatocellular carcinoma and significantly reduce the number of punctures.