超声引导技术对浅表恶性肿瘤的氩氦刀冷冻消融术中的应用  

Clinical application of endocare cryosurgical system in treating superficial solid tumor under the guidance by ultrasonography

作　　者：吉毅峥[1] 李文[2] 丁桂春[1] 简文豪[1] 刘积福[2] 张轻[1] 

机构地区：[1]北京军区总医院超声科,100700 [2]北京军区总医院氩氦刀治疗中心

出　　处：《中华普外科手术学杂志（电子版）》2014年第3期37-39,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的观察超声引导下氩氦刀冷冻治疗浅表实体肿瘤的近期疗效。方法对原发性或转移性或术后复发的浅表实体肿瘤共93例(包含118个病灶)经超声引导进行氩氦刀冷冻消融治疗,根据术中情况分为完全覆盖病灶组(99个病灶)和部分覆盖组(19个病灶),术后10 d、1个月及3个月超声进行复查。使用SPSS 13.0统计软件分析,计数资料采用卡方检验,以P<0.05为差异有统计学意义。结果所有患者均在术后10 d、1个月、3个月随访。术后10 d内全部瘤灶超声图象无明显改变;1个月后完全覆盖组的99个病灶78个病灶体积缩小,彩色多普勒血流显像信号明显减少或消失。3个月后完全覆盖的99个病灶中78个病灶体积缩小、形态模糊,无明显血流信号,部分覆盖组的19个病灶体积或不变或增大。术后3个月总有效率71.2%(84/118),冰球完全覆盖病灶组有效率78.8%(78/99)明显高于部分覆盖组有效率31.6%(6/19),两组差异有统计学意义(χ2=17.321,P<0.01)。结论氩氦刀治疗浅表实体肿瘤的疗效确定,超声引导氩氦刀冷冻治疗肿瘤过程有助于发挥其最大的冷冻效率,术后随访复查有助于了解患者的治疗效果。Objective To evaluate the short-term outcome of superficial solid tumor treated by using the endocare cryosungical system under the guidance of ultrasound . Methods 93 patients with （118 tumors） primary, secondany or postoperative recurrent superficial solid tumor were treated by using the endocare cryoswrgical system under the guidance of ultrasound . According to actual situation during operation, 118 tumors were divided into cover group （99 focus） and partial cover group （19 focus）. Follow-up by ultrasonogrphy （US） was performed at 10 days, 1 month and 3 months after cryoablation.Data analysis was performed by using SPSS 13.0 software, including the chi-square test for enumeration data use . AP value 〈0.05 was considered significantly different .Results All of the patients （ 100%） were followed up at 10 days , 1 month and 3 months after cryoablation .Follow-up examination by US after the cryoablation showed that the bodies of all tumors had no changes at 10 days after cryoablation compared with before operation .At 1 month and 3 months after cryoablation , the bodies of 78 tumors in the cover group decreased , with fewer signs or no signs of blood flow .However , the bodies of 19 tumors in the partial cover group enlarged at 3 months after cryoablation.The total effective rate was 71.2% （84/118）.The effective rate of the complete cover group was 78.8%（78/99）, while 31.6%（6/19） in the partial cover group （χ2 =17.321, P 〈0.01）.Conclusions The endocare cryosurgical system is effective in the treatment of superficial solid tumor .Guidance by ultrasonography could ensure the treatment to its great extent during the operation and plays an important role in the follow-up examination .

关 键 词：肿瘤 冷冻外科手术 超声检查 

分 类 号：R730.5[医药卫生—肿瘤] R445.1[医药卫生—临床医学]