超声引导下微波消融应用于皮下软组织恶性转移瘤的疗效评估

Evaluation of Ultrasound-Guided Microwave Ablation in Subcutaneous Soft Tissue Malignant Metastasis

摘要: 目的：探讨超声引导下微波消融(MWA)治疗皮下软组织恶性转移瘤的疗效。方法：回顾性分析确诊为皮下软组织恶性转移瘤并行超声引导下MWA治疗的50例患者的病历资料，原发性肿瘤均已稳定控制。要求患者术后规律随访，记录患者术后并发生及复发、转移发生情况，并评估术后随访期微波消融术消融区吸收疗效。结果：不同直径患者完全消融率比较差异有统计学意义(P < 0.05)，不同直径患者24月完全吸收率、复发率、转移率比较差异无统计学意义(P > 0.05)，24月复发率与转移率分别为20%、28%。在术后24月的随访过程中，结节的体积由5.62 ± 14.36 cm³减小至0.01 ± 0.04 cm³ (P < 0.05)，24月完全吸收率达76%。结论：超声引导下MWA对治疗皮下软组织恶性转移瘤效果可观，具有操作简单、实时监测、并发症少等优点；对于不宜行外科手术的患者，超声引导下MWA不失为一种较安全、有效的替代外科手术的治疗方法。

Abstract: Objective: To evaluate the efficacy of ultrasound-guided microwave ablation (MWA) in the treatment of subcutaneous soft tissue malignant metastasis. Methods: The medical records of 50 patients with subcutaneous soft tissue malignant metastasis treated with ultrasound-guided MWA were analyzed. Primary tumors had been stably controlled. Patients were required to follow up regularly after MWA, record the complications, recurrence and metastases of patients after MWA, and evaluate the absorption effect of microwave ablation area during postoperative follow-up. Results: There was significant difference in complete ablation rate among patients with different diameters (P < 0.05). There was no significant difference in 24-month complete absorption rate, recurrence rate and metastases rate among patients with different diameters (P > 0.05). The 24-month recurrence rate and metastases rate were 20% and 28% respectively. During the follow-up of 24 months after MWA, the volume of nodules decreased from 5.62 ± 14.36 cm³ to 0.01 ± 0.04 cm³ (P < 0.05), and the complete absorption rate was 76%. Conclusion: Ultrasound-guided MWA is effective in the treatment of subcutaneous soft tissue malignant metastasis. It has the advantages of simple operation, real-time monitoring and less complications. For patients who are not suitable for surgery, ultrasound-guided MWA is a safe and effective alternative therapy.