| Objectives To make clear that the therapeutic parameters of MTC-3 type multifunctional microwave therapeutic Equipment. To compare with the factors like hepatic artery ligation, local injection of anhydrous alcohol or hypotonic saline on the microwave coagulation necrotic ranges of impacts, so as to provide the basis for the clinical application. To compare with the curative effects on hepatocellular carcinoma by transcatheter arterial chemoembolization(TACE)+percutaneous microwave coagulation therapy(PMCT) or TACE+ percutaneous ethanol injection(PEI)+PMCT.Methods Simple microwave coagulation experiments with vitro porcine livers, power 50 w ~ 80 w, time 10 ~ 20 min, to record various ranges and shapes of the microwave coagulation on different parameters. Vitro porcine livers were divided into simple microwave group, ethanol group and hypotonic saline group, power 60 w, time 10 min, to compare with the ranges of microwave coagulation necrosis on different groups. Mongrel dogs were divided into simple microwave group, hepatic artery ligation group and the hepatic artery ligation + ethanol group, power 60 w, time 6 min, to compare with the ranges of microwave coagulation necrosis on different groups. 40 patients with HCCs , according to hospital admission orders, we divide them into two groups,TACE + PMCT and TACE + PEI + PMCT, 20 cases each, power (65±8.59) w, time (12.4±3.70) min. Follow-up 1 to 20 months, we intent to do the image, liver function and AFP inspections to evaluate theirs efficacy.Results Animal experiment : the range of microwave coagulation necrosis on vitro porcine liver was from(2.0±0.25) cm×(3.5±0.34) cm to (5.0±0.42) cm×(5.3±0.34) cm, the volumes of coagulation necrosis was from (7.34±4.05) cm3 to (69.43±11.78) cm3. We compared with the ranges of microwave coagulation necrosis among the simple microwave group, ethanol group and hypotonic saline group ,the largest is elcohol group, followed by saline group, both two groups were larger than simple microwave group significantly (P <0.05). Simple microwave group, hepatic artery ligation group and the hepatic artery ligation + ethanol group with live dogs has formed the range of microwave coagulation necrosis transverse diameter respectively is (1.26±0.39) cm, (1.67±0.32) cm, (2.10±0.34) cm, longitudinal diameter respectively is(2.32±0.54)cm,(3.21±0.67)cm,(3.60±0.69)cm.the last group has enlarge its range more than the former two groups significantly (P <0.05).Clinical study: TACE +PEI+PMCT group , AFP 10 cases turn to negative, negative rate was 90.9%(10/11),18 cases full necrosis,, the necrosis rate was 90.0%(18/20), TACE +PMCT group ,AFP 11 cases turn to negative, negative rate was 73.3%(11/15), 16 cases completely necrosis, necrosis rate was 80.0%(16/20).Between the two groups, the difference was not significant (P > 0.05)..Conclusions 1. Microwave experiments with vitro porcine liver defined that the parameters of the MTC-3-type multifunctional microwave instrument , which guide the clinical application of PMCT for hepatocellular carcinoma. 2. Through a variety of interventional factors'experiments, we defined that the hepatic artery ligation + ethanol could significantly expand the range of microwave coagulation necrosis, which provide the basis for the clinical application. 3. Choice TACE + PMCT or TACE + PEI + PMCT combination treatment for small hepatocellular carcinoma, we can achieve satisfactory results... |
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