立体定向放疗中B超引导下植入金标的可行性和安全性分析

发布时间：2018-04-29 22:14

本文选题：超声 + 立体定向放疗　；参考：《现代实用医学》2016年11期

【摘要】：目的评估在立体定向放疗中B超下植入金标的安全性和技术上成功率。方法回顾性分析77患者临床资料,77例患者在B超下植入金标90个(其中48个肝脏,26个胰腺,12个前列腺,4个肾上腺);金标植入过程中及植入完成后患者出现了一些相关并发症;能够进行治疗计划及CT扫描的金标植入为技术成功。结果90个金标的植入中,87个(96.7%)植入成功,3例需要重新进行金标的植入。其中2(2.2%)例患者发生植入金标移动,金标离肿瘤的距离超过3 cm,1例(1.1%)金标丢失致无法识别。1例(1.3%)患者出现严重并发症,6例(7.8%)出现轻微并发症。随着金标的植入患者主诉在插入位点局部疼痛合并右腰部疼痛,笔者采取了镇痛药和保守治疗,金标植入两周后,进行立体定向放疗CT定位扫描,患者没有出现进一步的并发症症状,2个被定位于肿瘤的金标一直完好。立体定向放疗治疗使肿瘤的大小1月内从约2.0 cm减少至0.5 cm。6例(7.8%)有轻微并发症的患者,住院过夜观察,其中4例患者有腹痛,不需要特殊处理,2例患者有轻度发烧,也不需要特殊的处理。3例B超引导下通过直肠植入金标的患者中,1例患者出现一过性血尿,症状持续1d,为给予特殊处理;1例患者出现暂时性排尿困难。结论在B超下经皮肤进行植入金标的并发症相对较低,但仍要仔细考虑金标位置移动过大及金标丢失致无法识别。
[Abstract]:Objective to evaluate the safety and technical success rate of gold standard implantation in stereotactic radiotherapy. Methods A retrospective analysis of the clinical data of 77 patients with gold labeling was performed in 77 patients (including 48 livers, 26 pancreas, 12 prostate, 4 adrenal gland), and some complications occurred during and after the implantation. A gold-label implant capable of planning treatment and CT scanning was successfully performed. Results of the 90 gold labeling implants, 87 were successfully implanted and 3 needed to be re-implanted. The distance from the gold label to the tumor was more than 3 cm-1 in 1 case. The loss of gold label resulted in the loss of gold label in 1 case, which could not be recognized in 1 case (1.3%). Serious complications occurred in 6 cases (7. 8%). With the main complaint of local pain and right waist pain at the insertion site, the author took analgesic and conservative treatment. Two weeks after the implantation of gold label, CT scanning was performed for stereotactic radiotherapy. No further complications were noted, and two gold markers located in the tumor remained intact. Stereotactic radiotherapy reduced the size of the tumor from about 2 cm to 0. 5 cm.6 in one month. Patients with minor complications were observed overnight, 4 of whom had abdominal pain and 2 had mild fever without special treatment. There was also no need for special treatment in 3 cases of gold standard implanted through the rectum under the guidance of B-ultrasound. One patient developed transient hematuria and the symptoms lasted for 1 day. In order to give special treatment, one patient had temporary difficulty in urinating. Conclusion the complications of gold labeling implanted through skin under B-ultrasound are relatively low, but it is still necessary to carefully consider that the location of gold label is too large and the loss of gold label can not be recognized.
【作者单位】：宁波市中医院;宁波市第一医院;南京医科大学第一附属医院;
【分类号】：R730.55

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