摘要
目的评估增强CT引导结合全身麻醉监控下射频消融治疗肾上腺转移瘤的疗效和安全性。方法在增强CT引导结合全身麻醉监控下对46例(52个病灶)肾上腺转移瘤患者进行射频消融治疗,评估技术成功率、肿瘤残余率、肿瘤复发率及并发症发生情况。结果 1例(1个病灶)因严重并发症终止消融治疗。41个病灶射频消融成功,技术成功率为80.39%(41/51),10个病灶局部残余,局部残余率为19.61%(10/51)。病灶最大径≥3cm与<3cm射频消融后的局部残余率差异有统计学意义(P=0.023)。严重并发症发生率4.35%(2/46),轻微并发症发生率34.78%(16/46),最常见的术中并发症为高血压危象(10/46,21.74%)。8个病灶在3~24个月[平均(11.52±7.33)个月]内复发,复发率为19.51%(8/41),其中7个再次接受消融治疗未复发,总的肿瘤局部控制率为76.92%(40/52)。结论增强CT引导结合全身麻醉监控下经皮射频消融能安全、有效地控制肾上腺转移瘤的局部进展。
Objective To evaluate the safety and efficacy of radiofrequency ablation treatment of adrenal metastases under enhanced CT guiding combined with general anesthesia monitoring.Methods Totally 46 patients with 52 adrenal metastases received radiofrequency ablation with percutaneous enhanced CT guiding combined with general anesthesia monitoring.The therapeutic outcomes were evaluated,including the presence of residual tumors,technical success rate,recurrence rate and complications.Results Ablation procedure was terminated because of severe complication in 1 patient.Radiofrequency ablation was successfully performed for 41 lesions,and the technical success rate was 80.39%(41/51).Residual tumor was found in 10 lesions(10/51,19.61%).The rate of residual lesions with tumor size<3 cm was significantly lower than that in tumor size≥3 cm(P=0.023).Severe complication rate was 4.35%(2/46),and the mild complication rate was 34.78%(16/46),with intraoperative hypertensive crisis as the most frequent complication(10/46,21.74%).Recurrence was observed in 8 lesions(8/41,19.51%)in 3-24 months after treatment(mean[11.52±7.33]months),and 7 lesions received secondary ablation treatment,while no recurrence was observed during the follow-up period.The overall local control rate was 76.92%(40/52).Conclusion Radiofrequency ablation with enhanced CT guiding combined with general anesthesia monitoring is a relatively safe and effective treatment for controlling adrenal metastases.
作者
周慷
石海峰
杨宁
金征宇
潘杰
ZHOU Kang;SHI Haifeng;YANG Ning;JIN Zhengyu;PAN Jie(Department of Radiology,Chinese Academy of Medical Sciences, Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中国介入影像与治疗学》
CSCD
北大核心
2018年第9期521-525,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
射频消融
肾上腺肿瘤
体层摄影术
X线计算机
麻醉
全身
Radiofrequency ablation
Adrenal gland neoplasms
Tomography,X-ray computed
Anesthesia,general
