Objective To preliminary explore the feasibility and safety of tuberculosis localized lesions with ultrasound-guided percutaneous microwave ablation.Methods 32 tuberculosis patients with 38 localized lesions confirmed by clinical and pathology,ultrasound-guided percutaneous microwave ablation,the lesion size,location,and the blood perfusion by contrast-enhanced ultrasound in the preoperative,the ablation range were observed in the postoperative,and the clinical curative effect and complications were also observed about 1 year follow-up.Results 9 lesions significantly narrowed down (narrow range ＞ 50％),1 lesion slightly narrowed down (narrow range ＜50％),28 lesions completely disappear,38 lesions have no contrast agent perfusion with contrast-enhanced ultrasound after microwave ablation.the clinical symptoms of all patients ease or disappear,no lesions appeared active progression or recurrence during the follow-up period.All patients have no serious complications,such as pleural reaction,pneumothorax,bleeding,adjacent organs damage and so on.Conclusions Ultrasound-guided percutaneous microwave ablation in the treatment of tuberculosis localized lesions have high safety,definite curative effect,and all patients have little pain and less trauma,which can be used as a new method of minimally invasive treatment in clinical promotion.%目的 初步探讨超声引导下经皮微波消融治疗结核局限性病变的可行性及安全性.方法 32例经临床和病理确诊的结核病患者,局限性病灶共38个,超声引导下经皮微波消融,术前超声造影观察病灶大小、部位、病灶内血流灌注,术后观察消融范围;随访约1年观察患者临床疗效及并发症发生情况.结果 微波消融后超声造影观察9个病灶范围明显缩小(缩小范围＞50％),1个病灶范围稍缩小(缩小范围＜50％),28个病灶完全消失,38个病灶消融后均无造影剂灌注.所有患者临床症状明显缓解或消失,随访期内未发现病灶出现活动性进展或复发.所有患者均未发生胸膜反应、气胸、出血、周围器官损伤等严重并发症.结论 超声引导下微波消融治疗结核局限性病变安全性高、疗效好,患者痛苦小、创伤少,可以作为一种新的微创治疗方法在临床上推广.
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