摘要
目的探讨集束电极射频治疗肝癌和肺癌的技术关键。方法Ⅲ～Ⅳ期肝癌112例,肺癌134例,CT或B超引导下经皮穿刺将集束电极射频针插入肿瘤组织进行射频热凝固治疗。术前进行肿瘤三维影像重建以确定穿刺点和进针途径。术中采用自制引导器辅助和校正穿刺。以肿瘤的部位、CT值及彩色超声血流情况等决定治疗功率及时间。根据治疗后的即时影像变化,判断是否需要重复治疗,根据术后随访的CT增强扫描决定是否需要二次治疗。结果246例患者手术成功率为100%,治疗有效率肝癌为92.5%,肺癌为90.8%,无一发生严重并发症。患者中位生存期肝癌为8.1个月,肺癌为15.2个月,明显优于对照组(肝癌3.9个月,肺癌7.7个月),患者生活质量较术前明显提高(χ2=137.84,P<0.01)。结论在肝癌及肺癌的集束电极射频治疗中,肿瘤的三维定位、射频针穿刺技术及治疗参数选择是提高治疗效果,减少并发症的技术关键。
Objective To explore the key technical issues of radio frequency ablation therapy for liver cancer and lung cancer.Methods 112 cases of liver cancer and 134 cases of lung cancer in stages Ⅲ～Ⅳ were treated with percutaneous ultrasound or CT guided cluster electrode radio frequency thermal ablation.We relocated the puncture point and the path with the three-dimensional display of the tumor before operation and adjusted the puncture path with self-made guiding equipment during operation.The treatment power and duration were decided by the location of the tumor,the lesions in CT scan and the blood stream in color Doppler imaging.The therapy might be repeated according to the instant image changes at that moment when the operation finished.The patient might need another therapy according to the result of CT intensified scan.Results 100% of the 246 patients had completed the operations successfully.92.5% of liver cancer sufferers and 90.8% of lung cancer sufferers were cured,without any severe complication.The median of survive terms were 8.1 months for liver cancer sufferers and 15.2 months for lung cancer sufferers,which were obviously longer than those of the antitheses(7.7 months for lung cancer sufferers and 3.9 months for liver cancer sufferers).The patients' life quality was also improved remarkably after the treatment(χ2=137.84,P<0.01).Conclusion The three-dimensional tumor positioning technology,the radio frequency puncture technology and the selection of appropriate treatment parameters are the key technical issues in improving the effectiveness of treatment and reducing the complications.
出处
《中国基层医药》
CAS
2005年第6期645-646,共2页
Chinese Journal of Primary Medicine and Pharmacy
基金
广东省高教厅科研基金项目(200067)
关键词
集束电极射频治疗
肝癌
肺癌
技术研究
Liver neoplasms
Lung neoplasm
Electrocoagulation
Antineoplastic protocols
Therapies,investigational
