中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2008年
6期
595-598
,共4页
史秋生%陈晨%杜联芳%赵勇洁%陈梅%陈晔%李杏梅
史鞦生%陳晨%杜聯芳%趙勇潔%陳梅%陳曄%李杏梅
사추생%진신%두련방%조용길%진매%진엽%리행매
恶性肿瘤%低温冷冻%微侵袭治疗
噁性腫瘤%低溫冷凍%微侵襲治療
악성종류%저온냉동%미침습치료
Malignant tumor%Argon-helium cryoablation%Microinvasive precedure
目的 探讨经皮氩氦刀冷冻对全身实体恶性肿瘤的治疗效果.方法 超声和CT引导下经皮氩氦刀冷冻治疗恶性肿瘤45例49个病灶,监测治疗区温度动态变化,冰球的大小、覆盖率和影像学表现,术后病灶缩小率.按肿瘤大小分成≤3 cm组和＞3 cm组,进行χ2检验、spearman分析.结果 治疗区温度1min内迅速降至-130～-150℃,并维持在-150℃左右.复温时治疗区温度1min内迅速回升至15℃左右.87.5%的冰球在冷冻开始后50 s内形成.冰球大小随时间延长增大.≤3 cm和＞3cm两组中,术中冰球覆盖率≥80%、＜80%者分别为72.7%、27.3%和26.3%、73.7%,两组比较差异有统计学意义(均P＜0.05).冰球声像图表现为弧形强回声带伴声影,CT表现为类圆形低密度区.术后3个月,≤3 cm和＞3cm两组病灶缩小率≥50%的分别占81.8%和30.6%,两组相比差异有统计学意义(P＜0.01).结论 经皮氩氦刀冷冻治疗恶性肿瘤,定位准确方便,治疗效果确切,小病灶效果显著,可应用于全身多部位.
目的 探討經皮氬氦刀冷凍對全身實體噁性腫瘤的治療效果.方法 超聲和CT引導下經皮氬氦刀冷凍治療噁性腫瘤45例49箇病竈,鑑測治療區溫度動態變化,冰毬的大小、覆蓋率和影像學錶現,術後病竈縮小率.按腫瘤大小分成≤3 cm組和＞3 cm組,進行χ2檢驗、spearman分析.結果 治療區溫度1min內迅速降至-130～-150℃,併維持在-150℃左右.複溫時治療區溫度1min內迅速迴升至15℃左右.87.5%的冰毬在冷凍開始後50 s內形成.冰毬大小隨時間延長增大.≤3 cm和＞3cm兩組中,術中冰毬覆蓋率≥80%、＜80%者分彆為72.7%、27.3%和26.3%、73.7%,兩組比較差異有統計學意義(均P＜0.05).冰毬聲像圖錶現為弧形彊迴聲帶伴聲影,CT錶現為類圓形低密度區.術後3箇月,≤3 cm和＞3cm兩組病竈縮小率≥50%的分彆佔81.8%和30.6%,兩組相比差異有統計學意義(P＜0.01).結論 經皮氬氦刀冷凍治療噁性腫瘤,定位準確方便,治療效果確切,小病竈效果顯著,可應用于全身多部位.
목적 탐토경피아양도냉동대전신실체악성종류적치료효과.방법 초성화CT인도하경피아양도냉동치료악성종류45례49개병조,감측치료구온도동태변화,빙구적대소、복개솔화영상학표현,술후병조축소솔.안종류대소분성≤3 cm조화＞3 cm조,진행χ2검험、spearman분석.결과 치료구온도1min내신속강지-130～-150℃,병유지재-150℃좌우.복온시치료구온도1min내신속회승지15℃좌우.87.5%적빙구재냉동개시후50 s내형성.빙구대소수시간연장증대.≤3 cm화＞3cm량조중,술중빙구복개솔≥80%、＜80%자분별위72.7%、27.3%화26.3%、73.7%,량조비교차이유통계학의의(균P＜0.05).빙구성상도표현위호형강회성대반성영,CT표현위류원형저밀도구.술후3개월,≤3 cm화＞3cm량조병조축소솔≥50%적분별점81.8%화30.6%,량조상비차이유통계학의의(P＜0.01).결론 경피아양도냉동치료악성종류,정위준학방편,치료효과학절,소병조효과현저,가응용우전신다부위.
Objective To observe the therapeutic effects of the parenchymal malignancies treated with argon-helium cryoablation percutaneouslly.Methods 49 foci in 45 patients with malignancies were treated with argon-helium cryoablation percutaneouslly.The temperature in the cryoablated area was dynamically recorded.The size and coverage of ice-balls formed were monitored.The imaging changes were observed.The shrinkage of tumor was followed 3 months post-cryoablation.The foci were divided into two groups in size:less than or equal to 3 cm and more than 3 cm.The chi-square test and spearman analysis were used by SPASS 11.0 software.Results The temperature in the cryoablated area descended fast to below-130℃ in a minute and relatively kept maintaince about-150℃ or so in the whole procedure.It ascended to 15℃ in a minute after rewarming.The ice-balls were formed within 50 seconds after cryoablation in 87.5% foci.And it increased in size as the time going.The coverages of the iceball more than or equal to and less than 80% were 72.7%、27.3% and 26.3%、73.7% in groups of less than or equal to 3 cm and more than 3 cm,respectively(P＜0.05).The ice-ball was demonstrated as arc hyperechogenicity with shadow and round-like low density on sonography and CT imaging,respectively.The shrinkage more than 50%of the foci was 81.8% and 30.6% in the groups of less than or equal to and more than 3 cm three months after the cryoabalated procedure(P＜0.01).Conclusion It is an actual/exact and convient way for the pereutaneous argon-helium cryoablation in treating malignancy.It can be used in the management of the parenchymal malignancy whole body.
