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目的 探讨超声引导瘤内微波固化 (PMCT)和高温蒸馏水注射 (PHDI)两种疗法对不能切除肝细胞癌 (HCC)的应用价值。 方法 PMCT治疗 5 0例HCC共 10 7个结节 ,直径 (2 7± 1 5 )cm ,最大者 6 4cm。对不能施行PMCT的病例 ,创立了PHDI,治疗 47例HCC共 6 9个直径 (2 5± 0 5 6 )cm的结节。 结果 PMCT后CT检查 94 4%结节完全坏死。 1年、2年和 3年生存率分别为 96 6 %、83 2 %和 72 8%。局部复发率 5 6 %。PHDI后 81 2 %的结节完全坏死。 1年、2年和 3年生存率分别为 91 5 %、78 4%和 49 5 %。局部复发率 13 0 %。 结论 PMCT疗效较注射治疗稳定可靠 ,且突破了介入超声仅适用于小肝癌的局限 ,应用前景广阔。PHDI突出优点是副反应轻微和费用低廉 ,适用于肝功能较差、肿瘤与肝内重要结构相邻或其他治疗条件受限者。综合运用多种介入超声治疗手段以适应不同个体的需要 ,将使更多的HCC患者受益
Objective To investigate the value of ultrasound-guided intratumoral microwave treatment (PMCT) and high-temperature distilled water injection (PHDI) in the treatment of unresectable hepatocellular carcinoma (HCC). Methods PMCT was used to treat 50 cases of HCC with 10 7 nodules, diameter (2 7 ± 1 5) cm, and the largest was 64 cm. For cases in which no PMCT could be performed, PHDI was created to treat 47 cases of HCC with a total of 69 diameter (2 5 ± 0 5 6 ) cm nodules. Results Post-PMCT CT examination revealed complete necrosis of 94% of the nodules. The 1-year, 2-year, and 3-year survival rates were 96.6%, 83. 2%, and 72.8%, respectively. The local recurrence rate was 56%. 81. 2% of the nodules were completely necrotic after PHDI. The 1-year, 2-year, and 3-year survival rates were 91.5%, 78.4%, and 49.5%, respectively. The local recurrence rate was 130%. Conclusion The curative effect of PMCT is more stable and reliable than that of injection therapy, and it breaks through the limitations of interventional ultrasound only for small hepatocellular carcinoma, and has broad application prospects. The outstanding advantages of PHDI are mild side effects and low costs, and it is applicable to those with poor liver function, tumors adjacent to important intrahepatic structures or other treatment conditions. Comprehensive use of a variety of interventional ultrasound therapy to meet the needs of different individuals will benefit more HCC patients