本文關(guān)鍵詞：超聲引導(dǎo)下納米刀治療危險(xiǎn)部位惡性腫瘤的短期療效及安全性評(píng)價(jià)　出處：《中國(guó)超聲醫(yī)學(xué)雜志》2017年05期 　論文類型：期刊論文

  更多相關(guān)文章： 納米刀 惡性腫瘤 危險(xiǎn)部位 短期療效 安全性評(píng)價(jià)

【摘要】：目的評(píng)估超聲引導(dǎo)下納米刀治療危險(xiǎn)部位惡性腫瘤的安全性和有效性。方法回顧性分析23例經(jīng)超聲引導(dǎo)下納米刀治療的危險(xiǎn)部位惡性腫瘤的術(shù)前術(shù)后資料,通過(guò)觀察術(shù)中、術(shù)后并發(fā)癥情況評(píng)估納米刀消融安全性;通過(guò)觀察術(shù)后癥狀緩解情況和術(shù)后1個(gè)月短期療效評(píng)估納米刀消融有效性。結(jié)果惡性腫瘤分布于胰腺、腹膜后、肝臟及頜面部,例數(shù)分別為16(69.5%)、3(13.1%)、2(8.7%)、2(8.7%)例,腫瘤平均大小(3.5±1.2)cm;采用開(kāi)腹、經(jīng)皮、經(jīng)口底超聲引導(dǎo)下消融的病例數(shù)分別為20(87.0%)、2(8.7%)、1(4.3%)例;所有患者均順利完成納米刀消融,6例(26.1%)患者出現(xiàn)術(shù)中不良反應(yīng),包括1例(4.3%)心率、血壓持續(xù)波動(dòng)和5例(21.7%)一過(guò)性血壓升高;術(shù)后不良反應(yīng)及并發(fā)癥,包括低位不完全性腸梗阻1例(4.3%),胃排空障礙4例(17.4%),室上性心動(dòng)過(guò)速、高血壓、心律不齊等心血管并發(fā)癥3例(13.0%),所有患者均治愈出院;93.3%以疼痛就診患者術(shù)后一周疼痛緩解,術(shù)后1個(gè)月增強(qiáng)影像學(xué)顯示消融灶范圍大于術(shù)前腫瘤范圍,消融灶內(nèi)見(jiàn)無(wú)增強(qiáng)區(qū),53.8%胰腺癌患者腫瘤標(biāo)記物較術(shù)前降低。結(jié)論超聲引導(dǎo)下納米刀治療危險(xiǎn)部位惡性腫瘤是安全和有效的,但其遠(yuǎn)期療效以及消融術(shù)后的影像學(xué)評(píng)估仍有待下一步深入研究。
[Abstract]:Objective to evaluate the safety and efficacy of ultrasound-guided nano-knife in the treatment of malignant tumors in dangerous areas. The safety of nano-knife ablation was evaluated by observing the complications during and after operation. Results the malignant tumors were located in pancreas, retroperitoneal, liver and maxillofacial region. The average size of the tumor was 3.5 鹵1.2 cm. The number of patients who underwent laparotomy, percutaneous and transoral ultrasound guided ablation were 200.87.0 and 8.7g / L, respectively. All the patients successfully completed the ablation of nano-knife in 6 patients with 26.1) the adverse reaction occurred in the operation, including one patient with 4.3) heart rate. Continuous fluctuation of blood pressure and transient elevation of blood pressure in 5 cases. Postoperative adverse reactions and complications included low incomplete intestinal obstruction in 1 case, gastric emptying in 4 cases, supraventricular tachycardia and hypertension in 4 cases. Cardiovascular complications such as arrhythmia were found in 3 cases, and all the patients were cured and discharged. 93.3% pain relief was observed in patients with pain one week after operation. Enhanced imaging showed that the range of ablation focus was larger than that of preoperative tumor, and no enhancement area was found in the ablation focus 1 month after operation. 53.8% tumor markers in patients with pancreatic cancer were lower than those before operation. Conclusion Ultrasound-guided nano-knife is safe and effective in the treatment of malignant tumors at risk. However, its long-term effect and imaging evaluation after ablation still need to be further studied.
【作者單位】： 廣州市中山大學(xué)附屬第一醫(yī)院超聲科;廣州市中山大學(xué)附屬第一醫(yī)院肝膽外科;
【基金】：國(guó)家自然科學(xué)基金面上項(xiàng)目(No.81371555)
【分類號(hào)】：R445.1;R730.5
【正文快照】： [　　手術(shù)切除是大部分惡性腫瘤的首選治療手段1]。危險(xiǎn)部位惡性腫瘤通常指腫瘤緊鄰或侵犯周圍大血管、神經(jīng)等重要組織,此類腫瘤常因手術(shù)風(fēng)險(xiǎn)大、術(shù)后并發(fā)癥多而使失去手術(shù)機(jī)會(huì),臨床上亟須安全有效的局部治療方式。物理消融是常用局部治療手段,其通過(guò)高溫或低溫引起蛋白變性而，

本文編號(hào)：1429058