超声引导下纳米刀治疗危险部位恶性肿瘤的短期疗效及安全性评价

发布时间：2018-01-15 16:07

  本文关键词：超声引导下纳米刀治疗危险部位恶性肿瘤的短期疗效及安全性评价　出处：《中国超声医学杂志》2017年05期 　论文类型：期刊论文

  更多相关文章： 纳米刀 恶性肿瘤 危险部位 短期疗效 安全性评价

【摘要】：目的评估超声引导下纳米刀治疗危险部位恶性肿瘤的安全性和有效性。方法回顾性分析23例经超声引导下纳米刀治疗的危险部位恶性肿瘤的术前术后资料,通过观察术中、术后并发症情况评估纳米刀消融安全性;通过观察术后症状缓解情况和术后1个月短期疗效评估纳米刀消融有效性。结果恶性肿瘤分布于胰腺、腹膜后、肝脏及颌面部,例数分别为16(69.5%)、3(13.1%)、2(8.7%)、2(8.7%)例,肿瘤平均大小(3.5±1.2)cm;采用开腹、经皮、经口底超声引导下消融的病例数分别为20(87.0%)、2(8.7%)、1(4.3%)例;所有患者均顺利完成纳米刀消融,6例(26.1%)患者出现术中不良反应,包括1例(4.3%)心率、血压持续波动和5例(21.7%)一过性血压升高;术后不良反应及并发症,包括低位不完全性肠梗阻1例(4.3%),胃排空障碍4例(17.4%),室上性心动过速、高血压、心律不齐等心血管并发症3例(13.0%),所有患者均治愈出院;93.3%以疼痛就诊患者术后一周疼痛缓解,术后1个月增强影像学显示消融灶范围大于术前肿瘤范围,消融灶内见无增强区,53.8%胰腺癌患者肿瘤标记物较术前降低。结论超声引导下纳米刀治疗危险部位恶性肿瘤是安全和有效的,但其远期疗效以及消融术后的影像学评估仍有待下一步深入研究。
[Abstract]:Objective to evaluate the safety and efficacy of ultrasound-guided nano-knife in the treatment of malignant tumors in dangerous areas. The safety of nano-knife ablation was evaluated by observing the complications during and after operation. Results the malignant tumors were located in pancreas, retroperitoneal, liver and maxillofacial region. The average size of the tumor was 3.5 卤1.2 cm. The number of patients who underwent laparotomy, percutaneous and transoral ultrasound guided ablation were 200.87.0 and 8.7g / L, respectively. All the patients successfully completed the ablation of nano-knife in 6 patients with 26.1) the adverse reaction occurred in the operation, including one patient with 4.3) heart rate. Continuous fluctuation of blood pressure and transient elevation of blood pressure in 5 cases. Postoperative adverse reactions and complications included low incomplete intestinal obstruction in 1 case, gastric emptying in 4 cases, supraventricular tachycardia and hypertension in 4 cases. Cardiovascular complications such as arrhythmia were found in 3 cases, and all the patients were cured and discharged. 93.3% pain relief was observed in patients with pain one week after operation. Enhanced imaging showed that the range of ablation focus was larger than that of preoperative tumor, and no enhancement area was found in the ablation focus 1 month after operation. 53.8% tumor markers in patients with pancreatic cancer were lower than those before operation. Conclusion Ultrasound-guided nano-knife is safe and effective in the treatment of malignant tumors at risk. However, its long-term effect and imaging evaluation after ablation still need to be further studied.
【作者单位】： 广州市中山大学附属第一医院超声科;广州市中山大学附属第一医院肝胆外科;
【基金】：国家自然科学基金面上项目(No.81371555)
【分类号】：R445.1;R730.5
【正文快照】： [　　手术切除是大部分恶性肿瘤的首选治疗手段1]。危险部位恶性肿瘤通常指肿瘤紧邻或侵犯周围大血管、神经等重要组织,此类肿瘤常因手术风险大、术后并发症多而使失去手术机会,临床上亟须安全有效的局部治疗方式。物理消融是常用局部治疗手段,其通过高温或低温引起蛋白变性而，

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