喉罩全麻下闭合式MRI引导微波消0.0554融治疗膈下肝恶性肿瘤  

Closed MRI-guided microwave ablation of subdiaphragmatic malignant liver malignanttumors under general laryngeal mask anesthesia

作　　者：许凯豪 王艳萍[1] 王朝艳[1] 李兆南 李艳爽 吴昆鹏 焦德超[1] 韩新巍[1] XU Kaihao;WANG Yanping;WANG Chaoyan;LI Zhaonan;LI Yanshuang;WU Kunpeng;JIAO Dechao;HAN Xinwei(Department of International Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052

出　　处：《中国介入影像与治疗学》2021年第3期129-132,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：河南省中青年卫生健康科技创新人才项目(YXKC2020037);河南省卫健委省部共建青年项目(SB201902014)。

摘　　要：目的探讨喉罩全麻通气下闭合式MRI引导微波消融治疗膈下肝恶性肿瘤的可行性。方法对36例膈下肝恶性肿瘤(肝转移瘤21例、肝癌15例)患者于喉罩全麻下行3.0T闭合式MRI引导下微波消融治疗,记录消融效果、不良反应及预后等指标。结果36例均操作成功,技术成功率100%;全麻效果评级均为Ⅰ级,平均图像质量评分(2.91±0.22)分,平均麻醉清醒时间(9.35±1.33)min,平均手术时间(51.52±10.66)min。术中1例发生气胸(肺压缩10%);术后2例发生反应性右侧胸腔积液、4例发热,未见膈穿孔、肝脓肿、大出血等严重并发症。术后2个月肿瘤完全消融率97.22%(35/36),肝肾功能与术前比较差异均无统计学意义(P均>0.05)。中位随访时间9.2个月,局部复发率2.78%(1/36)。结论喉罩全麻通气下闭合式MRI引导微波消融治疗膈下肝恶性肿瘤疗效较好,且安全、可行。Objective To explore the feasibility of closed MRI-guided microwave ablation of subdiaphragmatic malignant liver tumors under general laryngeal mask anesthesia.Methods Totally 36 patients with subdiaphragmatic malignant liver tumors(21 cases of liver metastases,15 cases of primary liver cancer)underwent 3.0T closed MRI-guided microwave ablation under general laryngeal mask anesthesia.The ablation effect,adverse reactions and prognosis,etc.were recorded.Results The technical success rate was 100%.The general anesthesia effect ratings were all gradeⅠ.The average image quality score was(2.91±0.22)points,and the average awake time of anesthesia was(9.35±1.33)min.The mean operation time was(51.52±10.66)min.Pneumothorax(10%pulmonary compression)occurred in 1 case during operation.After operation,reactive right pleural effusion was observed in 2 cases,while 4 patients had fever.No serious complication such as diaphragmatic perforation,hepatic abscess and massive hemorrhage occurred.Two months after operation,the complete ablation rate was 97.22%(35/36).No significant difference of liver and kidney function was found before and 2 months after operation(all P>0.05).With a median follow-up of 9.2 months,the local recurrence rate was 2.78%(1/36).Conclusion Closed MRI-guided microwave ablation under general laryngeal mask anesthesia was valuable and feasible for treating subdiaphragmatic malignant liver tumors.

关 键 词：肝肿瘤 麻醉 全身 磁共振成像 微波消融 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]