CAJ | 학술논문

目的探讨超声引导下单极冷循环射频消融(RFA)治疗毗邻胸壁周围型肺癌的疗效及安全性.方法对35例周围型肺癌患者的35个肿瘤行超声引导下 RFA 治疗.治疗后1~3个月行增强 CT(CECT)扫描,评价治疗疗效,如肿瘤灭活不全或复发行追加治疗;治疗后6~12个月复查 CECT 评估中远期疗效.结果35例患者 RFA 治疗顺利,治疗后第1~3个月 CECT 复查,肿瘤无强化为68.6%(24/35),肿瘤部分强化为31.4%(11/35),对肿瘤部分强化者行再次 RFA 治疗.治疗后6~12个月 CECT复查,肿瘤无强化71.4%(25/35),肿瘤增大并部分强化28.6%(10/35). RFA 治疗10d 后血清 CYFRA21-1水平与治疗前比较差异无统计学意义(P >0.05);治疗后20d 及30d 分别与治疗前比较 CYFRA21-1水平明显下降,差异有统计学意义(P <0.05).结论超声引导单极冷循环 RFA 治疗毗邻胸壁的周围型肺癌,能实时观察进针方向,操作方便,穿刺成功率高,并发症少,费用较低,是一种安全、可行、有效的治疗方法.
목적탐토초성인도하단겁랭순배사빈소융(RFA)치료비린흉벽주위형폐암적료효급안전성.방법대35례주위형폐암환자적35개종류행초성인도하 RFA 치료.치료후1~3개월행증강 CT(CECT)소묘,평개치료료효,여종류멸활불전혹복발행추가치료;치료후6~12개월복사 CECT 평고중원기료효.결과35례환자 RFA 치료순리,치료후제1~3개월 CECT 복사,종류무강화위68.6%(24/35),종류부분강화위31.4%(11/35),대종류부분강화자행재차 RFA 치료.치료후6~12개월 CECT복사,종류무강화71.4%(25/35),종류증대병부분강화28.6%(10/35). RFA 치료10d 후혈청 CYFRA21-1수평여치료전비교차이무통계학의의(P >0.05);치료후20d 급30d 분별여치료전비교 CYFRA21-1수평명현하강,차이유통계학의의(P <0.05).결론초성인도단겁랭순배 RFA 치료비린흉벽적주위형폐암,능실시관찰진침방향,조작방편,천자성공솔고,병발증소,비용교저,시일충안전、가행、유효적치료방법.
@@@@ Objective To evaluate the efficacy and safety of treating the peripheral lung cancer by ultrasound -guided unipolar cool-tip radiofrequency ablation(RFA).Methods Thirty-five masses of 35 peripheral lung cancer cases were treated by ultrasound -guided RFA.1 ~3 months after being treated,these cases undergone RFA were examined by CECT to evaluate the efficacy .If insufficiency inactiva-tion or palindromia,these cases would be treated by RFA again and examined with CECT 6 ~12 months later to evaluate the long term effica-cy.Results Thirty-five cases were treated by RFA successfully .1 ~3 months after RFA treatment,68.6%(24 /35) masses showed no en-hancement and 31.4%(11 /35) showed partial enhancement.These cases showing partial enhancement were treated by RFA again .6 ~12 months after RFA,the CECT results showed no enhancement in 71.4%(25 /35) cases and enlargement and partial enhancementin in 28.6%(10 /35) cases.There was no significant difference in serum CYFRA21-1 level between 10 days after RFA and before RFA(P >0.05).But 20 or 30 days after RFA treatment,the serum CYFRA21-1 level was significantly lower than before RFA (P <0.05).There was no serious complications after RFA treatment except 4 cases with mild pneumothorax,2 cases with moderate or marked pneumothorax tread by thoracic closed drainage and 1 case with subcutaneous emphysema .Conclusion Ultrasound guided cool-tip RFA can make needling direction be real -timely observed and it is convenient ,with high puncture success rate,less complications and low cost.It is a safe,feasible and effective meth-od of treating the peripheral lung cancer .