超声引导经皮微波消融脾肿瘤的疗效分析

发布时间：2018-04-08 07:48

本文选题：微波消融　切入点：超声　出处：《南方医科大学学报》2015年03期

【摘要】：目的分析超声引导经皮微波消融脾肿瘤的可行性、安全性和有效性。方法 7例患者共8个病灶行微波消融治疗,病理诊断分别为卵巢转移癌2个,肺、胃、肝、直肠转移癌各1个,血管瘤1个,炎性假瘤1个,肿瘤最大直径1.3~6.2(3.1±1.9)cm。水冷微波天线在超声引导下经皮植入肿瘤内,消融中一根20 G热敏电偶测温针植入瘤周5 mm处实时监测热场温度。微波辐射功率设置50~60 W。治疗后1、3、6月以及之后每隔6个月行增强影像(超声造影、CT/MRI)检查评判疗效。结果所有肿瘤均经1次微波消融治疗达到完全坏死。在中位随访13(4~92)月内无肿瘤局部进展发生。影像检查消融区边界清晰且随时间延长逐渐缩小。1例卵巢癌脾转移患者消融后11月脾脏新生另一病灶,再次行微波消融后完全坏死。转移癌患者消融后中位生存期13.0(4.0~92.0)月。除发热和腹痛外无治疗相关严重并发症发生。结论微波消融治疗适合的脾脏肿瘤患者是一种安全有效的微创介入技术。
[Abstract]:Objective to analyze the feasibility, safety and efficacy of ultrasound guided percutaneous microwave ablation of splenic tumors.Methods 7 patients with 8 lesions were treated with microwave ablation. The pathological diagnosis was ovarian metastatic carcinoma (n = 2), lung, stomach, liver and rectum metastasis (n = 1), hemangioma (n = 1) and inflammatory pseudotumor (n = 1).The water-cooled microwave antenna was implanted into the tumor under the guidance of ultrasound. During ablation, a 20G thermocouple thermometer was implanted into the tumor to monitor the temperature of the thermal field in real time at 5 mm around the tumor.The microwave radiation power is set at 50 ~ 60 W.At 1: 3, 6 months and 6 months after treatment, CT / MRI was performed to evaluate the efficacy.Results all tumors were completely necrotic after one microwave ablation.No local tumor progression occurred during a median follow-up of 13 ~ 4 ~ 92 months.The boundary of ablation area was clear and gradually decreased with time. 1 cases of ovarian cancer patients with splenic metastasis had a new splenic neoplasm one month after ablation and complete necrosis after microwave ablation again.The median survival time of patients with metastatic carcinoma was 13.0 ~ 4.0 ~ 92.0) months after ablation.There were no serious complications associated with treatment except fever and abdominal pain.Conclusion Microwave ablation is a safe and effective minimally invasive interventional technique for splenic tumor patients.
【作者单位】：解放军总医院介入超声科;
【基金】：国家自然科学基金(81071210,81127006) 北京市自然科学基金青年基金(7144246)~~
【分类号】：R445.1;R733.2

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