CT引导下经皮肺微波消融术中疼痛的风险评估  

Risk assessment of pain associated with CT-guided lung microwave ablation

作　　者：王丽娜[1] 刘建 史宏璐 韩旭健 窦卫涛 王学亮[1] WANG Lina;LIU Jian;SHI Honglu;HAN Xujian;DOU Weitao;WANG Xueliang(Department of Respiratory,The Fifth People’s Hospital of Jinan Affiliated to Shandong Second Medical University,Jinan 250022,China;Department of Medical Imaging Interventional Therapy,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第二医科大学附属济南市第五人民医院呼吸科,山东济南250022 [2]山东第一医科大学附属省立医院医学影像介入治疗科,山东济南250021

出　　处：《医学影像学杂志》2025年第2期55-59,共5页Journal of Medical Imaging

摘　　要：目的评估经皮肺微波消融术的疼痛效应并探讨导致消融相关中重度疼痛的危险因素。方法随机性选取接受CT引导下经皮微波消融术的肺肿瘤或肺结节患者,分为中重度疼痛组(93例)和轻度或无疼痛组(85例)。比较两组的临床资料、病灶特征和消融参数的差别,评估上述因素与消融所致中重度疼痛相关性。结果与轻度或无疼痛组相比,中重度疼痛组的病灶深度[(10.1±5.2)mm vs(19.4±6.2)mm;P=0.009]和穿刺深度[(29.5±6.7)mm vs(40.3±7.3)mm;P=0.012]更浅,总消融时间[(7.3±2.7)min vs(5.1±2.6)min;P=0.031]更长,胸膜受累发生率(35.5%vs 20.0%;P=0.015)和多针消融使用率(20.4%vs 8.2%;P=0.003)更高,差异有统计学意义。Logistic回归显示病灶深度[OR 0.69(95%CI:0.53~1.57);P=0.011]、穿刺深度[OR 0.63(95%CI:0.34~2.21);P=0.016]和使用多针消融[OR 4.14(95%CI:1.12~10.33);P=0.023]与消融所致中重度疼痛显著相关。结论病灶靠近胸膜、穿刺深度过浅和使用多针消融会增加消融相关疼痛的风险,影响肺微波消融疗效。Objective To evaluate the effects of intraoperative pain in percutaneous microwave ablation and to explore the risk factors moderate to severe pain associated with ablation.Methods Consecutive patients with lung tumors or nodules underwent CT-guided percutaneous microwave ablation were divided into moderate or severe pain(MSP,n=93)and mild or no pain(MNP,n=85)groups.We compared the differences in clinical data,lung lesion characteristics,ablation treatment parameters between MSP and MNP group,and evaluated associations between above factors and moderate or severe pain caused by lung ablation.Result Compared with MNP group,there were lower depth of lesion[(10.1±5.2)mm vs(19.4±6.2)mm;P=0.009]and puncture[(29.5±6.7)mm vs(40.3±7.3)mm;P=0.012],longer total ablation time[(7.3±2.7)min vs(5.1±2.6)min;P=0.031],higher pleural involvement(35.5%vs 20.0%;P=0.015)and using multi-antennas(20.4%vs 8.2%;P=0.003)in MSP group.Logistic regression analysis showed that lesion depth[OR 0.69(95%CI:0.53-1.57);P=0.011],puncture depth[OR 0.63(95%CI:0.34-2.21);P=0.016],and using multi-antennas[OR 4.14(95%CI:1.12-10.33);P=0.023]were significantly correlated with moderate to severe pain associated with ablation.Conclusion Lesion close to pleura,low depth of puncture and using multi-antennas increase the risk of ablative pain,which reduces the local efficacy of lung ablation therapy.

关 键 词：肺肿瘤 微波消融 疼痛 穿刺 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]