超声CT引导多点布针单极冷循环射频消融治疗周围型肺癌的对比研究  

The Comparative Study of Ultrasound-guided、CT-guided Multi-point Fabric Need Cool-tip Radiofrequency Ablation in the Treatment of Peripheral Lung Cancer

作　　者：高振森[1] 黄进[1] 李丹丹[1] 李文伦[1] 张玉杰[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院超声科,山东省潍坊市261041

出　　处：《中国超声医学杂志》2013年第10期882-886,共5页Chinese Journal of Ultrasound in Medicine

基　　金：山东省自然基金项目(No.Y2008C97)

摘　　要：目的评估超声和CT引导下多点布针单极冷循环射频消融（radiofrequence ablation，RFA）治疗周围型肺癌的疗效及安全性。方法将60例周围型肺癌患者分成A、B2组。A组：超声引导组35例；B组：CT定位组25例，应用单极冷循环RFA系统治疗。治疗后1～3个月行增强cT（CECT）复查，观察肿瘤灭活情况，如有残留追加治疗；治疗后6个月行CECT复查，评估近期疗效；治疗后12～24个月CECT复查，评估远期疗效。结果60例患者RFA治疗顺利，治疗后1～3个月行CECT复查，肿瘤未强化为66．7％（40／60），部分强化为33．3％（20／60），其中A组11例，B组9例，对部分强化行再次RFA治疗。治疗后6～24个月行CECT复查，肿瘤体积较治疗前明显缩小71．7％（43／60），肿瘤体积较前增大并部分强化28．3％（17／60）。2组比较差异无统计学意义P〉0．05。RFA治疗10d后血清CYFRA21-1水平与治疗前比较，P〉0．05差异无统计学意义；治疗后20d及30d分别与治疗前比较CYFRA21-1水平明显下降，P〈0．05差异有统计学意义。结论超声引导下多点布针RFA治疗毗邻胸壁周围型肺癌，穿刺成功率高，能实时观察进针方向，操作方便，并发症少，费用低，是一种安全、有效的治疗方法。Objective To evaluate the efficacy and safety of treating the peripheral lung cancer by multi point fabric need cool tip radiofrequeney ablation （ radiofrequence ablation, RFA ）under the guidance of ultrasound and CT. Methods 60 cases of peripheral lung cancer were divided into A, B group, respectively, by the guidance of ultrasound and CT application of Cool-tip treatment system of RFA treatment. After being treated 1 - 3 months, review was made by CECT to observe the conditions of tumor inactivation, if any residual additional treatment was nlade. After 6 months, CECT review was smoothly finished, to evaluate the curative effect of the near future. After 12-24 months, CECT was made review again to evaluate the curative effect of the long term. Results In 60 cases of patients, RFA treatment was smoothly finished, 1-3 months after treatment follow up CECT was made, without tumor enhance ment is 66.7% （40/60）, partial reinforcement is 33.3G （20/60）, the partial reinforcement including 11 cases of A group,and 9 cases of group B, were treated with RFA treatment again. 6 - 24 months after treatment follow-up CECT, showed that tumor volume was significantly reduced by 71.70% （43/60）, tumor volume is increased and some enhancement in 28.3% （17/60）. The two groups had no significant difference in P〉0.05. Compared with pre-treatment, after 10 d＇s RFA treatment, the serum levels of CYFRA21-1 didn＇t vary, P〉0.05 with no significant difference, and after 20 d and 30 d＇s RFA treatment, the serum levels of CYFRA21-1 significantly decreased respectively, P d0.05 showing that there was significant difference. Conclusions Ultrasound-guided multi-point fabric need Cool-tip RFA treating peripheral lung cancer adjacent to the walls of chest, which has high success rate of puncture, real-time observation of the needling direction, convenient operation, few complications and low cost, is a safe and effective treatment method.

关 键 词：超声检查 单极冷循环 肺肿瘤 射频消融术 增强CT 

分 类 号：R734.2[医药卫生—肿瘤]