活检同步微波消融治疗肋胸膜下肺结节的安全性及有效性  

Safety and efficacy of biopsy combined with microwave ablation for costal subpleural pulmonary nodules

作　　者：乔元岗[1] 刘现闯 鲍志宇 刘松[1] 田瑞玲 邱忠华[1] QIAO Yuangang;LIU Xianchuag;BAO Zhiyu;LIU Song;TIAN Ruiling;QIU Zhonghua(Department of Vascular and Oncology Interventional Medicine,Affiliated Hospital of Jining Medical University,Jining 272000,China;Department of Oncology and Hematology,Jining Third People's Hospital,Jining 272114,China)

机构地区：[1]济宁医学院附属医院血管肿瘤介入医学科,山东济宁272000 [2]山东省济宁市第三人民医院肿瘤血液科,山东济宁272114

出　　处：《医学影像学杂志》2023年第8期1386-1389,共4页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:202203100773)。

摘　　要：目的探讨CT引导下穿刺活检同步微波消融治疗肋胸膜下肺结节的安全性及有效性。方法选取31例患者31个高度可疑恶性肋胸膜下肺结节行CT引导下穿刺活检同步微波消融的资料,采用消融-活检-再消融治疗模式,首先行低功率低温微波凝固技术预消融病灶,其次行经皮穿刺活检术,最后行根治性微波消融治疗。分析患者的临床资料、技术成功率、并发症及近期疗效,评价活检同步微波消融治疗肋胸膜下肺结节的安全性及有效性。结果活检同步微波消融治疗肋胸膜下肺结节技术成功率为100%,穿刺活检阳性率为93.5%,完全消融率为93.5%。术后3、6和12个月随访,总体局部无进展生存期率(LPFS)分别为87.1%、77.4%和70.9%。术后1例出现重度疼痛,2例发生气胸,1例出现胸腔积液,5例出现发热,无针道转移及死亡发生。结论CT引导下穿刺活检同步微波消融治疗肋胸膜下肺结节安全有效。Objective To evaluate the effect of CT-guided percutaneous biopsy combined with microwave ablation for the treatment of costal subpleural pulmonary nodules.Methods The clinical data of 31 patients with 31 highly suspected malignant costal subpleural pulmonary nodules,who received CT-guided percutaneous biopsy combined with microwave ablation from April 2221 to March 2022,were retrospectively analyzed.The ablation-biopsy-re-ablation treatment mode was adopted.First,low-power low-temperature microwave coagulation technique was used to pre-ablate the lesion,followed by percutaneous biopsy,and finally microwave ablation was performed.We collected the clinical data,technical success rate,complications and short-term efficacy,and evaluated the safety and efficacy of biopsy combined with microwave ablation in the treatment of costal subpleural pulmonary nodules.Results The technical success rate was 100%,the diagnostic positive rate of needle biopsy was 93.5%.The rate of complete ablation was 93.5%and the local progression-free survival rates at 3,6 and 12 months were 87.1%,77.4%and 70.9%,respectively.Postoperative complications included severe pain(n=1),pneumothorax(n=2),pleural effusion(n=1)and fever(n=5).No death occurred.Conclusion For the diagnosis and treatment of highly suspected malignant costal subpleural pulmonary nodules,CT-guided percutaneous biopsy combined with microwave ablation is safe and effective.

关 键 词：肺结节 肋胸膜 微波消融 介入性 放射学 

分 类 号：R734.2[医药卫生—肿瘤] R815[医药卫生—临床医学]