不可逆电穿孔消融肿瘤围手术期并发症分析  

Irreversible electroporation ablation of tumor:an analysis of perioperative complications

作　　者：秦子淋 牛立志[2] 梁冰[2] 周亮[2] 方刚[2] 钱伟[2] 朱玮冰 徐炯源[2] 胡勇[2] 曾健滢[2] 陈继冰[2] 徐克成[2] 

机构地区：[1]暨南大学医学院,广州510632 [2]暨南大学附属广州复大肿瘤医院

出　　处：《介入放射学杂志》2018年第3期223-227,共5页Journal of Interventional Radiology

摘　　要：目的总结分析不可逆电穿孔消融多部位肿瘤在围手术期发生的并发症及处理。方法对接受不可逆电穿孔术的200例肿瘤患者(胰腺肿瘤71例、肝肿瘤64例、其它肿瘤65例)在围手术期发生的并发症进行观察及统计,分析严重并发症发生的原因及其处理。结果术中无一例死亡。术后严重并发症发生在胰腺和肝脏肿瘤消融,包括3例胰腺肿瘤术后10、11、15 d出现十二指肠动脉出血,2例肝肿瘤术后9 d消化道出血和胆道感染性休克,经介入栓塞和/或血管结扎手术后和抗感染治疗得以控制。轻微并发症经过对症治疗均在14 d以内缓解。结论不可逆电穿孔消融术全身性炎性反应少、术中、后不良反应可控,安全性较高。该疗法虽仍可能损伤胰腺肿瘤内或周边血管,但针对其原因进行改善,我们可以有效避免出现严重并发症。Objective To summarize and analyze the perioperative complications of irreversible electroporation（IRE） ablation in treating tumors at different locations and to discuss their managements.Methods A total of 200 patients with tumors, including pancreatic tumor（n=71）, liver tumor（n=64） and other tumors（n =65）, were enrolled in this study. All patients received IRE ablation treatment. The perioperative complications were recorded and the data were statistically analyzed. The causes of severe complications and the treatment of complications were discussed. Results None of the patients died during the course of IRE ablation procedure. Severe postoperative complications occurred in the patients with pancreatic tumor or liver tumor, including duodenal artery bleeding in 3 patients with pancreatic tumor,which occurred at 10 days, 11 days and 15 days after IRE ablation respectively, and gastrointestinal bleeding（n=1） and biliary septic shock（n=1） in 2 patients with liver tumor, which occurred at 9 days after IRE ablation, the clinical symptoms were controlled after interventional embolization and/or vascular ligation together with anti-infective therapy. All minor complications were relieved after symptomatic treatment within 14 days. Conclusion IRE ablation has less systemic inflammatory response, and both the intraoperative and postoperative adverse reactions can be easily controlled, besides, IRE ablation has higher clinical safety.Although IRE ablation procedure may damage the internal or peripheral vessels of the pancreatic tumor, this severe complications can be effectively avoided if proper measures are adopted based on the causes of complications.

关 键 词：不可逆电穿孔消融 肿瘤 围手术期 不良反应 

分 类 号：R735.7[医药卫生—肿瘤]