氩氦刀冷冻消融治疗孤立性肺结节的临床观察  

Argon-helium cryoablation therapy for solitary pulmonary nodule

作　　者：刘丽[1] 邵天朋 曹建民[1] 卢光明[1] 许健[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院医学影像科,南京210002

出　　处：《临床肿瘤学杂志》2014年第12期1128-1131,共4页Chinese Clinical Oncology

摘　　要：目的探讨氩氦刀冷冻消融术在孤立性肺结节治疗中的应用价值和安全性。方法回顾性分析2006年1月至2014年5月经CT诊断的34例孤立性肺结节患者的临床资料。患者均接受病灶穿刺活检及氩氦刀冷冻消融手术治疗。术后采用CT成像评价氩氦刀治疗的临床疗效。结果所有患者CT均诊断为恶性病变。穿刺病理诊断为腺癌25例,鳞癌6例,结肠癌转移瘤3例。34例患者均顺利完成氩氦刀冷冻消融术。术中CT显示冰球完全覆盖病灶30例,另4例冰球覆盖90%病灶。术后3个月复查CT显示,获CR 18例,PR 12例,NC 4例,有效率为88.2%。术后6个月复查CT显示,获CR 18例,PR 12例,NC 2例,PD 2例,有效率为88.2%。术后12个月复查CT显示,获CR 18例,PR 10例,NC 1例,PD 5例,有效率为82.3%。术后出现2例无症状性气胸,8例少量咯血,5例轻度胸痛,10例轻度胸闷,6例发热。术中及术后未出现胸腔积液、皮下气肿以及肺部感染的患者。术后2、5年生存率分别为61.7%和38.2%。结论氩氦刀冷冻消融术是治疗无法外科手术切除的孤立性肺结节的安全、有效的方法。Objective To evaluate the value and safety of argon-helium cryoablation in the treatment of solitary pulmonary nodule（ SPN）. Methods The clinical data of 34 patients who diagnosed as SPNs by CT from January 2006 to May 2014 were reviewed. All the patients underwent biopsy and argon-helium cryoablation. CT features was applied to evaluate the clinical efficacy of argon-helium cryoablation treatment. Results All patients were diagnosed as malignant lesions by CT imaging. There were 34 patients diagnosed as 25 lung adenocarcinoma,6 lung squamous cancer and 3 colon metastatic cancer by biopsy. The 34 patients were successfully completed argon-helium cryoablation treatment. Intraoperative CT view demonstrated that the focal area of ice hockey completely covered 30 cases,and the other 4 cases of ice hockey covering 90% lesions. There were not intraoperative and postoperative pleural effusion,subcutaneous emphysema and pulmonary infection. Three months after operation,the CT scan displayed that there were CR in18 patients,PR in 12,NC in 4 patients,and the effective rate was 88. 2%. Six months after operation,the CT scan displayed that there were CR in 18 patients,PR in 12 patients,NC in 2,PD in 2 patients,and the effective rate was 88. 2%. Twelve months after operation,the CT scan displayed that there were CR in 18 patients,PR in 10 patients,NC in 1 patient,PD in 5 patients,and the total effective rate was 82. 3%. There were pneumothorax without symptoms in 2 cases,a small number of haemoptysis in 8 cases,mild chest pain in 5 cases,mild chest tightness in 10 cases,and fever in 6 cases after the operation. The 2-,5-year survival rate was61. 7% and 38. 2%. Conclusion Argon-helium cryoablation is safe and effective treatment for SPN that can’t resected by surgery.

关 键 词：孤立性肺结节 氩氦刀冷冻消融术 经皮穿刺活检 

分 类 号：R730.56[医药卫生—肿瘤]