DynaCT 3D iGuide穿刺技术在肺癌微波消融中的应用  

Application of DynaCT combined with 3D iGuide puncture technique to microwave ablation of lung cancer

作　　者：范晨 唐浩桓 周奇 孙飞虎 丁伟 孙磊 王维涛 徐平 王卫东 FAN Chen;TANG Haohuan;ZHOU Qi;SUN Feihu;DING Wei;SUN Lei;WANG Weitao;XU Ping;WANG Weidong(Department of Intervention,Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi,214023,Jiangsu,P.R.China)

机构地区：[1]南京医科大学附属无锡人民医院介入科,江苏无锡214023

出　　处：《中国胸心血管外科临床杂志》2023年第2期221-225,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨3D iGuide穿刺技术引导下的DynaCT微波消融(microwave ablation,MWA)治疗肺癌的可行性及安全性。方法回顾性分析2019年6月—2020年12月南京医科大学附属无锡人民医院行DynaCT MWA治疗的19例原发性或转移性肺癌患者的临床资料,其中男15例、女4例,平均年龄(64.9±11.7)岁。记录手术成功率、并发症、术后住院时间及局部治疗效果。结果19例患者均完成消融,技术成功率100.0%,平均穿刺定位时间(15.7±3.7)min,平均消融时间(5.7±1.6)min。消融前接受同步穿刺活检的患者13例,病理结果阳性10例(76.9%)。术后不良反应主要为疼痛7例(36.8%)、咳嗽2例(10.5%)和消融后综合征4例(21.1%)。轻微并发症主要为气胸6例(31.6%)、出血5例(26.3%)、胸腔积液2例(10.5%)和空洞1例(5.3%)。3例患者发生中等量气胸,需胸腔闭式引流。消融后住院时间为2.0(2.0,3.0)d,围手术期无患者死亡。术后1个月随访初始完全消融率89.5%(17例),不完全消融率10.5%(2例),所有患者均未出现局部进展。结论3D iGuide系统引导下的肺癌DynaCT MWA安全可行,短期局部控制率较高,远期疗效有待进一步观察。Objective To investigate the feasibility and safety of DynaCT microwave ablation(MWA)guided by3D iGuide puncture technology for lung cancer.Methods The clinical data of 19 patients with primary or metastatic lung cancer who underwent DynaCT MWA from June 2019 to December 2020 in our hospital were retrospectively analyzed,including 15 males and 4 females with an average age of 64.9±11.7 years.The technical success rates,adverse reactions and complications,postoperative hospital stay,and local therapeutic efficacy were recorded.Results Technical success rate was 100.0%.The mean time required to target and place the needle was 15.7±3.7 min and the mean ablation time was 5.7±1.6 min.Thirteen patients underwent biopsy synchronously before the ablation,and 10(76.9%)patients had positive pathological results.The main adverse reactions were pain(7/19,36.8%),post-ablation syndrome(4/19,21.1%)and cough(2/19,10.5%).The minor complications were pneumothorax(6/19,31.6%),hemorrhage(5/19,26.3%),pleural effusion(2/19,10.5%)and cavity(1/19,5.3%).Three patients had moderate pneumothorax and received closed thoracic drainage.The median hospitalization time after ablation was 2.0(2.0,3.0)d,and no patient died during the perioperative period.The initial complete ablation rate was 89.5%(17 patients)and the incomplete ablation rate was 10.5%(2 patients)at 1-month follow-up,and no local progression was observed.Conclusion DynaCT MWA of lung cancer under the guidance of 3D iGuide system is safe and feasible with a high short-term local control rate,but the long-term efficacy remains to be further observed.

关 键 词：DYNACT 肺肿瘤 微波消融 介入治疗 

分 类 号：R734.2[医药卫生—肿瘤]