超声引导微波消融治疗T1a期肾癌的安全性评估  

Ultrasound guided percutaneous microwave ablation treatment for renal carcinomas at T1a stage: the safety evaluation in clinical application

作　　者：程志刚[1] 梁萍[1] 于晓玲[1] 韩治宇[1] 刘方义[1] 于杰[1] 陈洪峰[1] CHENG Zhigang LIA NG Ping YU Xiaoling HA N Zhiyu LIU Fangyi YU Jie CHEN Hongfeng(Department of Interventional Ultrasound, PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院介入超声科,北京100853

出　　处：《中国医药导报》2017年第13期105-108,F0004,共5页China Medical Herald

基　　金：国家科技支撑计划课题(2013BAI01B00)

摘　　要：目的评价超声引导经皮微波消融治疗T1a期肾癌临床应用的安全性。方法 2009年9月~2015年12月,回顾性研究在解放军总医院行超声引导微波消融治疗的112例T1a期肾癌患者的病例资料,共计119枚肿瘤,最大径0.9~4.0 cm,平均(2.82±0.79)cm;术后随访2~68个月,平均(25.3±17.2)个月。安全性评估通过术后并发症和副作用表现以及患者术前术后肾功能变化进行。结果术后出现严重并发症3例(2.7%),包括结肠穿孔1例,尿瘘1例,治疗区旁假性动脉瘤形成1例。轻微并发症和副作用分别为20例(17.9%)和18例(16.1%)。6例术前已因肾功能衰竭而行透析治疗的患者安全有效完成了消融治疗,其余106例患者术后末次随访时肾功能指标与术前比较,差异无统计学意义(P>0.05)。结论超声引导经皮微波消融治疗是T1a期肾癌患者可选的一种安全方法,术后对肾功能无显著影响。Objective To evaluate the clinical safety of percutaneous microwave ablation （MWA） treatment for renal car- cinomas at Tla stage under ultrasound （US） guidance. Methods From September 2009 to December 2015, the clinical data of 112 patients at Tla stage with 119 renal carcinomas proven histopathologically were retrospectively analyzed. All the tumors were performed the procedure of US-guided percutaneous MWA at Chinese PLA General Hospital. The mean maximal diameter of the tumors was （2.82±0.79） cm （range from 0.9 to 4.0 cm） and the mean follow-up period was （25.3±17.2） months （range from 2 to 68 months）. The clinical safeties were assessed by thepresentations of the compli- cations and side effects following the procedure and patients＂ renal function before and after MWA. Results The major complications occurred in three patients （2.7%） after MWA, including colonic perforation, urinary fistula and pseudoa- neurysm formation adjacent to the ablated zone. 20 cases （17.9%） with minor complications and 18 ones （16.1%） with side effects were presented after procedures. MWA was safely and effectively completed for 6 patients on dialysis be- cause of renal function failure before ablation. For the other 106 ones, the indexes of renal function such as serum cre- atinine and blood urea nitrogen at last follow-up were shown no statistical difference to the ones of pre-ablation （P 〉 0.05）. Conclusion US-guided percutaneous MWA would be a safe alternative for the treatment of patients with renal carcinomas at Tla stage with no significant influence to renal function after ablation.

关 键 词：超声引导 微波 消融 肾癌 

分 类 号：R737.11[医药卫生—肿瘤]