李勇，王永霞，王翻身，张渊包头市蒙医中医医院普外科，内蒙古包头 014040

经皮水冷式微波固化术与手术再切除治疗复发性肝癌的疗效

李勇，王永霞，王翻身，张渊
包头市蒙医中医医院普外科，内蒙古包头 014040

目的探究对复发性肝癌病例使用经皮水冷式微波固化术治疗的疗效。方法随机抽取在2013年1月—2015 年1月于该科室治疗胆囊结石的病例132例，按照随机数字表法将其分为治疗组和对照组两组，每组66例，两组分别使用经皮水冷式微波固化术和手术再切除治疗。对治疗后的效果及相关指标进行测评。 结果 治疗组1年（80.3%）、3年生存率（51.5）对照组相当（81.8%）、（48.5%）（P＞0.05），但5年生存率（43.9%）明显大于对照组（30.3%）（P=0.047＜0.05），且并发症发生及住院时间明显少于对照组，差异有统计学意义（P=0.000，0.114＜0.05）。结论经皮水冷式微波固化术能有效治疗复发性肝癌，是并发症较少的微创术，适合复发性肝癌长期治疗，值得推广。

疗效；微波固化术；经皮水冷式；肝癌；手术切除

［Abstract］Objective To discuss the curative effect of percutaneous water-cooled microwave coagulation therapy in treatment of recurrent liver cancer.Methods 66 cases of patients with gallstone treated in our department from January 2013 to January 2015 were randomly extracted and randomly divided into two groups with 66 cases in each，the two groups were respectively treated with percutaneous water-cooled microwave coagulation therapy and re-resection operation，and the effects after treatment and relevant indexes were evaluated.Results The 1-year and 3-year survival rates in the treatment group were equal to those in the control group，（80.3%，51.5%vs 81.8%，48.5%）（P＞0.05），but the 5-year survival rate in the treatment group was obviously more than that in the control group （43.9%vs 30.3%）（P=0.047），and the occurrence of complications and length of stay in the treatment group were obviously less than those in the control group，and all had obvious differences（P=0.000，0.114＜0.05）.Conclusion Percutaneous microwave coagulation therapy can effectively treat recurrent liver cancer，and it is a minimally invasive surgery with fewer complications，and it is suitable for long-term treatment of recurrent liver cancer，and it is worth promotion.

［Key words］Curative effect；microwave coagulation therapy；Percutaneous water-cooled；Liver cancer；Resection operation

肝癌主要指肝细胞癌，是我国最常见的恶性肿瘤之一，其死亡率一直居高不下。肝癌的复发和转移是影响其预后及远期转移的重要因素，是临床外科肝病研究的重要课题，临床上针对复发性肝癌的治疗手段包括手术再切除、肝移植及射频消融，但是，很大一部分患者由于多病灶难以切除，手术耐受性差，存在肝硬化、腹水等手术禁忌，无法进行手术，并且无法找到合适肝源进行移植，造成患者生存率极低。近年来，经皮微波固化术（PMCT）这种局部消融手段被广泛应用与临床并取得良好效果，水冷式PMCT更是通过降低消融针温度，防止针周组织的过早碳化，解决其固化范围不足的缺陷。……