CT引导下经皮复合式冷冻消融治疗肺恶性肿瘤的有效性及安全性  

Efficacy and safety of CT-guided percutaneous compound cryoablation for malignant lung tumors

作　　者：关海涛[1] 范则杨 王健[1] 佟小强[1] 邹英华[1] GUAN Haitao;FAN Zeyang;WANG Jian;TONG Xiaoqiang;ZOU Yinghua(Department of Interventional Radiology and Vascular Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院介入血管外科,北京100034

出　　处：《中国介入影像与治疗学》2023年第1期36-39,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的 观察CT引导下经皮复合式冷冻消融治疗肺恶性肿瘤的有效性和安全性。方法 回顾性分析22例接受CT引导下经皮冷热交替复合式冷冻消融治疗肺恶性肿瘤患者,根据病灶大小、形态及部位分为根治性消融(15例)及姑息性消融(7例),观察术中及术后4周内不良反应及并发症;于术后1、3、6个月复查胸部增强CT,以改良实体瘤疗效评价标准(mRECIST)评价疗效。结果 22例均顺利完成消融,术中无明显不良反应。6例术中及术后即刻出现少量气胸或液气胸,未经干预自行改善;2例术中局部皮肤轻度冻伤,予局部处理后缓解;1例术后1周出现大量气胸,给予胸腔闭式引流后恢复;无其他并发症。15例根治性消融术后1、3、6个月完全缓解分别为14例(14/15,93.33%)、14例(14/15,93.33%)及13例(13/15,86.67%);7例姑息性消融术后1、3、6个月局部缓解分别为7例(7/7,100%)、6例(6/7,85.71%)及4例(4/7,57.14%)。结论 CT引导下冷热交替复合式冷冻消融治疗肺恶性肿瘤短期效果确切、安全可控。Objective To observe the efficacy and safety of CT-guided percutaneous compound cryoablation for malignant lung tumors. Methods Data of 22 patients with malignant lung tumors who received CT-guided percutaneous compound cryoablation with alternating heat and cold were retrospectively analyzed. According to the size, morphology and location of the lesions, radical ablations were performed in 15 cases, while palliative ablations were performed in 7 cases. Adverse reactions and complications during operation and within 4 weeks after operation were observed. Enhanced thoracic CT was reviewed 1, 3 and 6 months after treatments, and the local ablation efficacy was evaluated using modified-response evaluation criteria in solid tumors(mRECIST). Results All ablation were successfully accomplished in 22 patients without obvious intraoperative adverse effects. Slight pneumothorax or hydropneumothorax occurred in 6 cases during and immediately after operation, and then recovered without intervention. Local skin frostbite was noticed in 2 cases during operation, which recovered after local treatment. One case suffered from delayed massive pneumothorax 1 week after operation and relieved through thoracic drainage. No other complications occurred. One, 3 and 6 months after operation, among 15 patients who underwent radical ablation, complete response was observed in 14(14/15, 93.33%), 14(14/15, 93.33%) and 13(13/15, 86.67%) cases, respectively, while among 7 cases who underwent palliative ablation, partial response was found in 7(7/7, 100%), 6(6/7, 85.71%) and 4(4/7, 57.14%) cases, respectively. Conclusion CT-guided compound cryoablation with alternating heat and cold for malignant lung tumors had definite short-term local effect and controllable safety.

关 键 词：肺肿瘤 冷冻消融 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R815[医药卫生—临床医学]