经同轴套管穿刺活检同步微波消融治疗高度可疑恶性肺结节  

Simultaneous core needle biopsy and microwave ablation via coaxial cannula for highly suspected malignant pulmonary nodules

作　　者：王东东 李晓光[1] 李彬[1] 别志欣 李元明 张江旭 孙洁[1] WANG Dongdong;LI Xiaoguang;LI Bin;BIE Zhixin;LI Yuanrning;ZHANG Jiangxu;SUN Jie(Chinese Academy of Medical Sciences,Peking Union Medical College,National Center of Gerontology,Beijing Hospital Minirnally-Invasive Therapy Center for Tumors,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京医院国家老年医学中心肿瘤微创治疗中心,北京100730

出　　处：《介入放射学杂志》2018年第11期1040-1044,共5页Journal of Interventional Radiology

摘　　要：目的评价CT引导下经同轴套管穿刺活检同步微波消融(MWA)治疗高度可疑恶性肺结节的安全性及有效性。方法回顾性分析2016年9月至2017年11月对57例患者65个高度可疑恶性肺结节行CT引导下穿刺活检及MWA的资料,其中A组23例(29个肺结节)经同轴套管穿刺活检后立即行MWA(同步诊治组),B组34例(36个肺结节)先行CT引导下经皮穿刺活检术,病理证实为恶性病变后接受MWA(序贯诊治组)。比较两组患者的临床资料、技术成功率、并发症及近期疗效,评价经同轴套管穿刺活检同步MWA的安全性及有效性。结果两组患者穿刺活检及MWA技术成功率均为100%。气胸发生率A组31.0%,B组58.3%,差异有统计学意义(P=0.028)。咯血及胸腔积液发生率A组均为24.1%(7/29),B组分别为27.8%(10/36)及22.2%(8/36),两组差异无统计学意义。随访6个月,两组均无其他并发症,治疗有效率均为100%。结论 CT引导下经同轴套管穿刺活检同步MWA治疗高度可疑恶性肺结节安全有效。Objective To evaluate the safety and efficacy of CT-guided simultaneous percutaneous core needle biopsy and microwave ablation（MWA） via coaxial cannula for highly suspected malignant pulmonary nodules. Methods The clinical data of 57 consecutive patients with 65 highly suspected malignant pulmonary nodules, who received CT-guided simultaneous percutaneous core needle biopsy and MWA via coaxial cannula during the period from September 2016 to November 2017, were retrospectively analyzed. The patients were divided into group A（n=23, 29 pulmonary nodules in total） and group B（n=34,39 pulmonary nodules in total）. Patients of group A received percutaneous core needle biopsy via coaxial cannula followed immediately by MWA（simultaneous diagnosis and treatment group）, and patients of group B received CT-guided percutaneous puncture biopsy, and, if the lesion was proved to be malignant by pathological examination, subsequent MWA was carried out immediatly（sequential diagnosis and treatment group）. The clinical data, technical success rates, complications and short-term effect were compared between the two groups, and the safety and effectiveness of simultaneous percutaneous core needle biopsy and MWA via coaxial cannula technique were evaluated. Results The technical success rate was 100% in both groups. The incidence of pneumothorax was 31.0% in group A and 58.3% in group B, the difference between the two groups was statistically significant（P=0.028）. The incidences of hemoptysis and pleural effusion in group A were 24.1%（7/29） and 24.1%（7/29） respectively, which in group B were 27.8%（10/36） and22.2%（8/36） respectively; the difference between the two groups was not statistically significant. The patients were followed up for 6 months, and no other complications occurred. The effective rate was 100% in both groups. Conclusion For the diagnosis and treatment of highly suspected malignant pulmonary nodules, CTguided simultaneous percutaneous core needle biopsy and MWA via coaxial cann

关 键 词：微波消融 穿刺活检 肺结节 同轴套管 

分 类 号：R734.2[医药卫生—肿瘤]