摘要目的：比较常规超声与超声造影引导复发性肝细胞癌（HCC）微波消融治疗的临床疗效。方法回顾性分析本院肝胆科2009年6月至2012年8月收治的复发性HCC并进行微波消融治疗的108例患者的临床资料。所有患者分为两组，观察组（69例，80个肿瘤灶）行超声造影引导复发性HCC微波消融治疗，对照组（39例，58个肿瘤灶）同期行普通超声引导复发性HCC微波消融治疗。术后1个月增强CT检查评价肿瘤完全消融率，记录患者的并发症发生情况和无瘤生存期。结果术后1个月，观察组与对照组增强CT评价肿瘤完全消融率分别为95.7%（66/69）、82.1%（32/39），组间比较差异有统计学意义（P=0.034）。观察组和对照组的无瘤生存期分别为（11.3±10.8）个月、（12.6±10.4）个月，差异无统计学意义（P=0.890）。两组患者术后疼痛、发热等并发症的发生率差异无统计学意义（均P>0.05）。结论超声造影能清晰显示常规超声显示不清的复发性HCC病灶，顺利实施引导消融的过程，提高肿瘤的完全消融率，但并不能延长患者的无瘤生存期。

abstractsObjective To evaluate the clinical benefit of percutaneous microwave ablation(PMA) in recurrent hepatocellular carcinoma(HCC)guided by conventional ultrasound versus contrast enhanced ultrasonography(CEUS). Methods Data of 108 patients admitted to Department of Hepatobiliary Oncology in our hospital between June 2009 and August 2012 with a final diagnosis of recurrent HCC and having undergone PMA were analyzed retrospectively. These patients were divided into 2 groups:the observation group[69 patients(80 lesions)]to receive PMA of recurrent HCC guided by CEUS,and the control group [39 patients(58 lesions)]to receive PMA of recurrent HCC guided by conventional ultrasound. The rate of complete ablation as assessed by enhanced CT at one month post?PMA,and the complications and disease?free survival(DFS)were recorded. Results At one month post?PMA,the rate of complete ablation as assessed by enhanced CT was 95.7%(66/69) in the observation group vs 82.1%(32/39) in the control group,with significant difference between two groups(P=0.034). The DFS was(11.3±10.8)months in the observation group vs(12.6±10.4)months in the control group,and the difference between two groups was not significant(P=0.890). There was no inter?group difference in post?PMA complications such as pain or fever (all P>0.05). Conclusion PMA guided by CEUS provides better imaging of recurrent HCC that is difficult with conventional ultrasound,and therefore improves the procedure and rate of complete ablation. However,CEUS?guided PMA does not prolong the DFS in the patients.