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June 20, 2023 epigastric MR:

1. Change of liver cancer post comprehensive treatment, segment S8 lesion decreased in size compared with prior scan, without evident active ingredient;

2. Abnormal signal lesion in liver S2 segment slightly decreased in size compared with prior scan, with change post treatment; new nodule in liver S4 segment.

    

1. primary liver cancer

2. Chronic viral hepatitis B

3. liver cirrhosis

4. essential hypertension

1. Patients supine, preoperative ECG monitoring, blood oxygen saturation monitoring; first B ultrasound scan clear tumor lesions located in the liver S4 segment, determine the puncture into the needle point.

2. Iodine disinfection of the skin at the puncture site, laying a perforated towel and a single, 2% lidocaine local anesthesia.

3. Under CT guidance, a 1.6mm microwave ablation needle was pierced through the skin into the upper and inner side of the S4 tumor. Set the corresponding power and time according to the size of the tumor (60W;3Min and 55W;4Min); The anesthesiologist started NS 9ml sufentanil 1ml dilution, took 2ml intravenous injection for analgesia, turned on the microwave ablation machine for microwave ablation therapy, and dynamically monitored the rod temperature and vital signs of the patient during ablation. A CT scan at the end of 7Min showed that the ablation area covered most of the inside of the tumor.

4. The microwave ablation needle was adjusted to the lower and outer side of the tumor under CT guidance again, and the corresponding power and time (50W;8Min) were set according to the size of the tumor. The microwave ablation machine was turned on for microwave ablation treatment, and the rod temperature and vital signs of the patient during ablation were dynamically monitored. A CT scan at the end of 8Min showed that the ablation area covered the entire tumor. Liver tumor ablation after the end of the needle, parallel needle tract ablation.

5. Postoperative CT scan showed no hepatic subcapsular hematoma, pneumothorax, hemothorax, subcapsular and abdominal bleeding, and no skin burning;

6. The patient did not complain of special discomfort, and his vital signs were stable. He returned to the ward after the puncture point was bandaged with gauze.