| 引用本文: | 高楠,牟培源,白媛媛,曾妮,谢芳,徐静.腹腔镜超声与经皮超声引导微波消融治疗复发性肝癌的临床应用[J].中国临床新医学,0,():-. |
| Gao Nan,Mu Pei-yuan,Bai Yuan-yuan,Zeng Ni,Xie Fang,Xu Jing.腹腔镜超声与经皮超声引导微波消融治疗复发性肝癌的临床应用[J].中国临床新医学,0,():-. |
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| 摘要: |
| 目的：探讨腹腔镜超声与经皮超声引导微波消融治疗复发性肝癌的临床应用。方法：腹腔镜超声或经皮超声引导微波消融治疗复发性肝癌各45例，术后采用影像学检查及实验室检查比较两组术后效果。随访0.5年、1年及1.5年，统计各组累积生存率及未复发生存率。结果：腹腔镜超声组80.33% 病灶位于特殊部位；经皮超声组3.45%病灶位于特殊部位。经皮超声组术中出血量、手术时间、术后住院时间均少于腹腔镜超声组。随访0.5年、1年、1.5年，腹腔镜超声组累积生存率为100%、88.9%、75.6%，经皮超声组为100%、82.2%、71.1%；腹腔镜超声组未复发生存率为71.1%、60.0%、37.8%，经皮超声组为66.7%、53.3%、31.1%。结论：经皮超声引导治疗更微创，腹腔镜超声更适用于特殊部位病灶。超声引导微波治疗适用于不能实施开腹手术的病人，使得治疗复发性肝癌的范围更广。 |
| 关键词: 腹腔镜超声 经皮超声 复发性肝癌 微波消融 |
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| Clinical Application of Microwave Ablation for Recurrent Hepatocellular Carcinoma under the Guidance of Laparoscopic Ultrasound and percutaneous ultrasound |
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Gao Nan,Mu Pei-yuan,Bai Yuan-yuan,Zeng Ni,Xie Fang,Xu Jing
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Eastern Hospital,Sichuan Provincial Medical Sciences Academy Sichuan Provincial People’s Hospital
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| Abstract: |
| Objective:To investigate the clinical effects of microwave ablation for recurrent hepatocellular carcinoma?under the guidance of laparoscopic ultrasound and percutaneous ultrasound. Methods:A total of 90 patients were treated with microwave ablation. They were divided into two groups(n=45) with the different guiding modality, which include laparoscopic ultrasound and percutaneous ultrasound in PLA rocket force charasteristic medical center from 2016-2019. All patients were estimated with color Doppler flow ultrasonography, enhancement computed tomography(CT) and blood tests. Finally, we summarized those results to get evaluation of clinicial effects . All patients were followed up with 6 months, 12 months , and 18 months. Results: Of the 61 lesions in laparoscopic ultrasound group, and 49 lesions(80.33%) were in difficult location such as closing to the diaphragm, gallbladder, stomach, or colon, and 2 of the 58 lesions(3.45%) were adjacent to diaphragm in percutaneous ultrasound group. In percutaneous ultrasound group, the amount of blood loss, operative time, postoperative hospital stay, total hospital stay were less than those of the laparoscopic ultrasound group(P=0.000). After the following 6 months, 12 months, and 18 months, we found that cumulative survival rate in laparoscopic ultrasound group was 100%, 88.9%, and 75.6%, while recurrence free survival rate of the group was 71.1%, 60.0% and 37.8%, respectively; In percutaneous ultrasound group, cumulative survival rate was 100%, 82.2%, and 71.1%, while recurrence free survival rate of the group was 66.7%, 53.3% and 31.1%, respectively.Conclusions: Percutaneous ultrasound procedure more minimally invasive than laparoscopic ultrasound procedure, laparoscopic ultrasound is more suitable for the difficult location. Laparoscopic and percutaneous ultrasound-guided microwave ablation can broaden the treatment procedure’s range of recurrent hepatocellular carcinoma. |
| Key words: Laparoscopic ultrasound Percutaneous ultrasound Recurrent hepatocellular carcinoma Microwave ablation |
