经皮肺穿刺氩氦刀靶向治疗老年原发性肺部恶性肿瘤的临床观察  

The clinical observation of the targeted Cryocare surgical system through percutaneous lung puncture for primary pulmonary malignant tumors in the elderly patient

作　　者：伏婷婷[1] 张宝和[1] 徐洪涛[1] 韩志海[2] 段蕴铀[2] 聂舟山[2] 王吉[1] 温居一[3] 

机构地区：[1]海军总医院干部保健科,北京100048 [2]海军总医院呼吸内科,北京100048 [3]海军总医院放射肿瘤科,北京100048

出　　处：《中国医学装备》2017年第6期69-73,共5页China Medical Equipment

摘　　要：目的:探讨经皮肺穿刺氩氦刀靶向治疗老年原发性肺部恶性肿瘤的临床疗效和安全性。方法:对227例70岁以上原发性肺部恶性肿瘤患者的230个病灶行经皮肺穿刺氩氦刀靶向冷冻消融治疗,术后即刻观察不同直径的肿瘤冰球覆盖情况,按实体瘤评价标准评价疗效,动态观察肺部肿瘤治疗前后的变化、并发症和生存率。结果:氩氦刀靶向治疗后肿瘤直径<4 cm的90个冰球覆盖率为(98.6±0.4)%,肿瘤直径>4 cm的140个冰球覆盖率为(90.3±5.4)%,两种不同直径的肿瘤冰球覆盖率比较,其差异有统计学意义(t=4.69,P<0.01)。术后1个月、3个月、6个月和12个月的有效缓解率(CP+PR)分别为56.4%、56.2%、55.4%和53.9%,组间比较差异均无统计学意义(x^2=3.705,x^2=3.500,x^2=1.604,x^2=0.935;P>0.05)。所有患者治疗过程安全,无死亡病例,术后发热81例(占35.7%),咯血31例(占13.7%),气胸18例(占7.9%),胸腔积液14例(占6.2%),冷休克1例,经对症处理恢复正常。随访6个月、1年、2年和3年,患者生存率分别为89%、68%、26%和12%,中位生存时间14个月。结论:CT引导下经皮穿刺氩氦刀靶向治疗肺部肿瘤对老年患者是一种有效、安全的治疗方法。Objective： To investigate the clinical efficacy and safety of targeted Cryocare surgical system through percutaneous lung puncture in the treatment of primary pulmonary malignant tumors for senile patients. Methods： The 230 lesions from 227 patients （over 70 years） with primary pulmonary malignant tumor were treated by using targeted Cryocare surgical system through percutaneous lung puncture. The coverage situations of tumor ice ball of different diameter were immediately observed, and the curative effects were evaluated as response evaluation criteria in solid tumors （RECIST）. Besides, the change, complication and survival rate of pulmonary malignant tumor before and after treatment were dynamic observed. Results： After the targeted cryocare surgery, the coverage rate of 90 ice balls （diameter of tumor was less than 4 cm） was （98.6±0.4）%, and the tumor diameters of 140 ice balls were larger than 4cm and their coverage rate was （90.3±5.4）%. The difference of the coverage rate of tumor ice ball between two kind diameters was significant （t=4.69, P〈0.01）. The effective remission rates （CP＋PR） post-surgery 1 month, 3 months, 6 months and 12 months were 56.4%, 56.2%, 55.4% and 53.9%, respectively, and there were no significant difference among these groups （x^2=3.705, x^2=3.500, x^2=1.604, x^2=0.935, P〉0.05）. The whole process of treatment was safety and there was no death cases, while 81 cases were fever post-operation （35.7%）, 31 cases were hemoptysis post-operation （13.7%）, 18 cases were pneumothorax post-operation （7.9%）, 14 cases were pleural effusion post-operation （6.2%） and 1 cases was cold shock post-operation. And all of them recovered to normal situation after were treated as their relative symptom. Follow-up of post-operation 6 months, 1 years, 2 years and 3 years, the survival rates of patients were 89%, 68%, 26% and 12%, and the median survival time was 14 months. Conclusion： CT guided percutaneous targeted cryocare surgical system for pul

关 键 词：氩氦刀 冷冻消融 老年 肺部肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]