CT引导经皮与电磁导航引导经支气管微波消融治疗肺磨玻璃结节近期疗效对比  

Comparison of short-term efficacy of CT-guided percutaneous and electromagnetic navigation bronchoscope-guided microwave ablation for pulmonary ground-glass nodules

作　　者：傅毅立[1] 张文谦[1] 陈硕[1] 李欣[1] 刘毅[1] 胡滨[1] 李辉[1] Fu Yili;Zhang Wenqian;Chen Shuo;Li Xin;Liu Yi;Hu Bin;Li Hui(Department of Thoracic Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院胸外科,北京100020

出　　处：《中华医学杂志》2021年第33期2576-2581,共6页National Medical Journal of China

摘　　要：目的比较CT引导经皮与电磁导航引导经支气管微波消融治疗肺磨玻璃结节的有效性。方法回顾性收集2018年1月至2020年10月首都医科大学附属北京朝阳医院胸外科及呼吸科收治的无法耐受手术的22例肺磨玻璃结节患者资料,男6例,女16例,年龄57~86(70.5±9.0)岁。患者经病理确诊为非小细胞肺癌(ⅠA期)。根据结节所在位置以及结节是否位于小气道旁选择给予CT引导经皮微波消融(CT组,17例)或电磁导航引导经支气管微波消融(电磁导航组,5例)。通过复查胸部CT评价病灶近期局部控制率,从而判定治疗的有效性,并对气胸、咯血、术后疼痛等手术并发症进行比较,评估其安全性。结果两组患者的年龄、性别、病灶的大小、实性成分及病灶所在区域等基本情况差异均无统计学意义(均P>0.05)。两组在术后疼痛、气胸及咯血等常见手术并发症方面差异均无统计学意义(均P>0.05)。近期疗效评价方面,术后1个月复查胸部CT,电磁导航组病灶缩小的患者比例较CT组高(4/5比2/17),差异具有统计学意义(P=0.003);术后3个月复查胸部CT,两组病灶缩小的患者比例差异无统计学意义[15/17(88.2%)比5/5(100.0%),P=0.420]。结论两种路径的微波消融治疗方法均可对已确诊的ⅠA期恶性肺磨玻璃结节达到良好的局部控制,电磁导航组治疗可以在术后1个月更早地判定治疗效果,常见并发症两组差异无统计学意义。Objective To compare the efficacy and the safety of computed tomography(CT)-guided percutaneous and electromagnetic navigation bronchoscope-guided microwave ablation in the treatment of pulmonary ground-glass nodules.Methods A retrospective study was conducted to collect the data of 22 patients with pulmonary ground-glass nodules(GGN)who were intolerant of lung resection.The participants,including 6 males and 16 females aged from 57 to 86 years with an average age of(70.5±9.0)years,were treated in the Department of Thoracic Surgery or Respiration Department of Beijing Chaoyang Hospital from January 2018 to October 2020.All of them were pathologically diagnosed as non-small cell lung cancer stageⅠA.According to the nodule location and the distance to the small airway,the participants were divided into two groups:CT group(n=17)and electromagnetic navigation group(n=5).Patients in the CT group underwent computed tomography-guided percutaneous microwave ablation,and patients in the electromagnetic navigation group were treated with electromagnetic navigation bronchoscope-guided microwave ablation therapy.The local control rate was used to evaluate the effectiveness of the treatment by reexamination of chest CT.Surgical complications such as pneumothorax,hemoptysis,and postoperative pain between two groups were compared to assess the safety.Results There was no statistically significant differences in age,gender,lesion size,solid component and lesion location between the two groups(all P>0.05).No significant differences were found in postoperative pain,pneumothorax and hemoptysis and other common surgical complications between the two groups(all P>0.05).In terms of short-term efficacy evaluation,when Chest CT was re-performed one month after surgery,the nodule shrink rate of patients in the electromagnetic navigation group was higher than that in the CT group(4/5 vs 2/17),and the difference was statistically significant(P=0.003);when Chest CT was re-performed three months after surgery,no significant difference was

关 键 词：肺结节 磨玻璃 计算机断层扫描 电磁导航支气管镜 微波消融 

分 类 号：R734.2[医药卫生—肿瘤]