CAJ | 학술논문

目的：观察和分析微波消融治疗肝海绵状血管瘤的并发症及其防治。方法2009年7月-2011年5月，对30例肝海绵状血管瘤患者共进行了34例次微波消融治疗。术后观察与微波消融治疗相关的并发症及其预后。结果共发生严重并发症2例（6.7%），其中急性溶血致急性肾衰竭1例，腹壁脓肿1例。术后出现发热18例（60%），短暂性血红蛋白尿4例（13.3%），恶心、呕吐5例（16.7%），术区明显疼痛8例（26.7%），右侧胸腔积液4例（13.3%），肝功能损害24例（80%），白细胞升高11例（36.7%）。无治疗相关死亡病例。结论微波消融治疗肝海绵状血管瘤虽然创伤小、安全性高、疗效好，但对于瘤体范围大或部位复杂者，仍存在有较大的风险。其中有一些并发症是可以及早发现并获得积极救治，避免及减少不良影响。
목적：관찰화분석미파소융치료간해면상혈관류적병발증급기방치。방법2009년7월-2011년5월，대30례간해면상혈관류환자공진행료34례차미파소융치료。술후관찰여미파소융치료상관적병발증급기예후。결과공발생엄중병발증2례（6.7%），기중급성용혈치급성신쇠갈1례，복벽농종1례。술후출현발열18례（60%），단잠성혈홍단백뇨4례（13.3%），악심、구토5례（16.7%），술구명현동통8례（26.7%），우측흉강적액4례（13.3%），간공능손해24례（80%），백세포승고11례（36.7%）。무치료상관사망병례。결론미파소융치료간해면상혈관류수연창상소、안전성고、료효호，단대우류체범위대혹부위복잡자，잉존재유교대적풍험。기중유일사병발증시가이급조발현병획득적겁구치，피면급감소불량영향。
Objective To analyze the complications caused by microwave ablation for hepatic cavernous hemangiomas, and to discuss the prevention and treatment of the complications. Methods During the period from July 2009 to May 2011 at authors’ hospital, a total of 34 times of microwave ablation procedure were carried out in 30 patients with hepatic cavernous hemangiomas. The microwave ablation-related complications were recorded and the prognosis was evaluated. Results Serious complications occurred in 2 patients (6.7%), including acute hemolysis leading to acute renal failure (n = 1) and abdominal wall abscess (n = 1). Postoperative fever was seen in 18 cases (60%), transient hemoglobinuria in 4 cases (13.3%), nausea with vomiting in 5 cases (16.7%), marked pain at the surgical area in 8 cases (26.7%), right pleural effusion in 4 cases (13.3%), hepatic dysfunction in 24 cases (80%) and leukocytosis in 11 cases (36.7%). No treatment-related death occurred. Conclusion For the treatment of hepatic cavernous hemangiomas, microwave ablation is minimally invasive with higher safety and satisfactory effect, although this technique carries somewhat higher risks when the hemangioma is larger or the location of the hemangioma is anatomically complicated. Some of these complications can be early detected and proper management should be actively adopted in order to avoid as well as to minimize the adverse results.