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超声引导下人工胸腔积液辅助微波消融治疗肝膈顶部肿瘤

[Ultrasound-guided microwave ablation with artificial pleural effusion for liver tumor adjacent to 
diaphragmatic dome].

作者信息

Tang Tian, Gu Shanzhi, Li Guowen, Huang Manping, Huang Bin, Xiong Zhengping

机构信息

Department of Intervention, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, 
Central South University, Changsha 410013, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Feb 28;42(2):184-188. doi: 10.11817/j.issn.1672-7347.2017.02.011.

Abstract

To explore the value of ultrasound-guided microwave ablation with artificial pleural effusion for liver tumor adjacent to diaphragmatic dome.
 Methods: A total of 34 patients with liver tumors located at diaphragmatic dome in Hunan Provincial Tumor Hospital were recruited from January 2014 to October 2015. The number of lesions ≤3 or lesion diameter ≤5 cm was in line with the microwave ablation indications. B ultrasound-guided microwave ablation for the liver tumors was undertaken after the artificial pleural effusion being established. 3-4 weeks later after the microwave ablation, all patients were imaged with enhance CT or MRI. The effect of ablation and the complications were evaluated.
 Results: There were 49 lesions in 34 patients, including 30 cases (88.2%) of complete ablation (CA), 3 cases (8.8%) of partial ablation (PA) and one case with new lesions after ablation (2.9%). Thirty-four patients had (1 580±230.7) mL of pleural effusion volume, while one case had bloody pleural effusion. One case had a diaphragmatic thermal injury, and one case had a biliary tumor infection. All of them showed remission after symptomatic treatment. 
 Conclusion: Combination of ultrasound-guided microwave ablation with artificial pleural effusion is a safe and effective therapy for liver tumor adjacent to diaphragmatic dome.

摘要

探讨人工胸水引导下超声微波消融治疗肝顶部肿瘤的价值。方法:选取2014年1月至2015年10月湖南省肿瘤医院收治的34例肝顶部肿瘤患者,病灶数≤3个或病灶直径≤5 cm符合微波消融指征,在建立人工胸水后行B超引导下肝肿瘤微波消融术,微波消融术后3~4周行增强CT或MRI检查,评估消融效果及并发症。结果:34例患者共49个病灶,完全消融(CA)30例(88.2%),部分消融(PA)3例(8.8%),消融后新发病灶1例(2.9%);34例患者胸水引流量为(1 580±230.7)ml,1例出现血性胸水,1例出现膈肌热损伤,1例出现胆系感染,经对症处理后均缓解。结论:人工胸水引导下超声微波消融治疗肝顶部肿瘤安全有效。

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