动脉栓塞联合氩氦刀序贯治疗小肾癌的临床疗效分析

发布时间：2018-07-06 10:39

本文选题：小肾癌 + 冷冻消融　；参考：《介入放射学杂志》2015年07期

【摘要】：目的探讨动脉栓塞(TAE)联合CT引导经皮氩氦刀序贯治疗小肾癌的安全性和疗效。方法收集2008年2月—2013年7月南京军区南京总医院医学影像科介入病房44例TAE联合CT引导经皮氩氦刀序贯治疗的小肾癌患者,术后1个月复查肾功能,术后1~3个月复查增强CT或增强MRI,采用m RECIST标准评价其疗效,并对患者进行12~46个月随访,平均随访时间28个月。结果 44例患者共48个病灶行TAE和氩氦刀序贯治疗,其中病灶完全缓解(CR)38个,部分缓解(PR)6个,病灶稳定(SD)4个,缓解率(CR+PR)为91.7%。所有患者均未发生严重并发症,仅1例患者冷冻过程中出现局限性出血,给予对症处理后好转。患者术后平均住院时间4 d,随访期间3例失访,1例因食管癌相关并发症死亡。40例患者随访期均存活,存活患者中5例于13~22个月后复发,后予以再次联合治疗。结论采用TAE联合CT引导经皮氩氦刀序贯治疗小肾癌微创、安全、有效,尤其是氩氦刀冷冻前进行栓塞可能降低冷冻过程中出血发生率,值得临床推广应用。
[Abstract]:Objective to evaluate the safety and efficacy of arterial embolization (Tae) combined with CT guided percutaneous argon-helium knife in the treatment of small renal cell carcinoma. Methods from February 2008 to July 2013, 44 patients with small renal cell carcinoma treated by Tae combined with CT guided percutaneous argon-helium knife were collected in interventional ward of Department of Medical Imaging, Nanjing General Hospital of Nanjing military region. Renal function was examined 1 month after operation. Enhanced CT or enhanced MRI were reexamined 1 ~ 3 months after operation. The efficacy was evaluated by m-RECIST standard. The patients were followed up for 12 ~ 46 months with an average follow-up time of 28 months. Results Forty-eight lesions of 44 patients were treated with Tae and Argon-helium knife sequential therapy, including 38 complete remission (CR), 6 partial remission (PR), 4 stable lesions (SD), and 91.7 remission rate (CR PR). There were no serious complications in all patients, but only one patient had local hemorrhage during freezing, which was improved after symptomatic treatment. The average hospitalization time was 4 days after operation. During the follow-up period, 1 case died of esophageal cancer related complications in 3 cases and 40 cases survived during the follow-up period. Among the patients, 5 cases recurred after 13 ~ 22 months, and then they were treated again with combined therapy. Conclusion it is safe and effective to use Tae combined with CT guided percutaneous argon-helium knife in the sequential treatment of small renal cell carcinoma. Especially, embolization before cryopreservation may reduce the incidence of hemorrhage during cryopreservation, which is worthy of clinical application.
【作者单位】：徐州医学院研究生院;南京军区南京总医院医学影像科;
【分类号】：R737.11

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