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目的探讨小肝癌合并严重肝硬化经CT引导微波消融治疗的安全性及应用价值。方法选择小肝癌患者55例(肝癌瘤体64个),用国产ECO-100微波刀,经CT定位引导后在局麻下将微波针头经皮肝穿刺进入瘤体进行微波消融。结果 55例64个肝癌瘤体经过消融治疗,全部瘤体原位毁损。随访期间复发9例:原肿瘤区边缘复发4例,肝内复发3例,肺部转移和骨转移各1例。30例患者治疗后出现肝功能障碍,经对症处理均好转。结论小肝癌合并严重肝硬化经过保肝治疗后可以耐受微创微波治疗,但是需要CT精确引导。
Objective To investigate the safety and application value of CT-guided microwave ablation of small hepatocellular carcinoma with severe cirrhosis. Methods Fifty-five patients with small hepatocellular carcinoma (64 hepatocellular carcinomas) were selected and treated with a local ECO-100 microwave knife guided by CT. Microwave percutaneous transhepatic needle puncture was performed under local anesthesia to perform microwave ablation. Results 55 cases of 64 liver cancer tumor after ablation, all the tumor in situ damage. During the follow-up period, 9 cases were recurred: 4 cases had edge recurrence in the original tumor area, 3 cases had liver recurrence, and 1 case had pulmonary metastasis and bone metastasis. After treatment, 30 cases of liver dysfunction, the symptomatic treatment were improved. Conclusion Small hepatocellular carcinoma with severe cirrhosis can be tolerated minimally invasive microwave treatment after liver protection treatment, but need accurate guidance of CT.