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目的:探讨经皮水冷式微波固化单针消融系统治疗毗邻胆囊、胃肠道、肝内主要血管、膈肌的特殊部位肝肿瘤的安全性与疗效。方法:从2009年7月至2011年6月,33例特殊部位肝肿瘤患者(肿瘤最大径≤5 cm且肿瘤数目≤3,毗邻部位:胆囊8例,胃肠道9例,门静脉右支11例,下腔静脉1例,膈肌4例)接受经皮水冷式微波固化术,探讨其安全性、并发症、固化范围及其疗效。结果:33例患者共42个肿瘤[肿瘤直径介于2.1～4.6 cm,平均直径为(3.4±0.9)cm]接受微波水冷式微波固化术,围术期无严重并发症,3例患者出现右侧胸腔积液;水冷式微波固化范围为(4.8±1.1)cm(固化范围介于3.5～6.0cm),共41个肿瘤取得完全消融,完全消融率为97.6%;1例毗邻横结肠肿瘤固化不完全经补充治疗后取得完全固化。结论:水冷式微波固化单针消融系统治疗特殊部位肝肿瘤是安全的,能产生较大固化范围,对于直径≤5cm肝肿瘤基本能达到完全固化的目的,是安全的微创治疗手段。
Objective: To investigate the safety and efficacy of transcutaneous water-cooled microwave-cured single needle ablation system in the treatment of liver tumor in the special parts of the adjacent gallbladder, gastrointestinal tract, major blood vessels in the liver and diaphragm. Methods: From July 2009 to June 2011, 33 patients with liver tumor with special site (maximal tumor diameter ≤5 cm and tumor number ≤3, adjoining site: 8 cases of gallbladder, 9 cases of gastrointestinal tract, right portal vein 11 Cases, 1 case of inferior vena cava, 4 cases of diaphragm) received percutaneous water-cooled microwave curing, to explore its safety, complications, scope of curing and its efficacy. Results: A total of 42 tumors in 33 patients (tumor diameter ranging from 2.1 to 4.6 cm and average diameter of (3.4 ± 0.9) cm) underwent microwave water-cooled microwave coagulation. There were no serious complications during the perioperative period. Three patients showed right Side pleural effusion. The range of water-cooled microwave curing was (4.8 ± 1.1) cm (range of cure was 3.5 ~ 6.0cm). Complete ablation was achieved in 41 tumors and the complete ablation rate was 97.6% Completely cured after full treatment. Conclusion: The water-cooled microwave-cured single needle ablation system is safe and can produce a large range of solid tumors. It is a safe and minimally invasive treatment for the purpose of completely curing the diameter ≤ 5cm of liver tumors.