本文選題：超聲 + 立體定向放療��； 參考：《現(xiàn)代實用醫(yī)學》2016年11期

【摘要】：目的評估在立體定向放療中B超下植入金標的安全性和技術上成功率。方法回顧性分析77患者臨床資料,77例患者在B超下植入金標90個(其中48個肝臟,26個胰腺,12個前列腺,4個腎上腺);金標植入過程中及植入完成后患者出現(xiàn)了一些相關并發(fā)癥;能夠進行治療計劃及CT掃描的金標植入為技術成功。結果90個金標的植入中,87個(96.7%)植入成功,3例需要重新進行金標的植入。其中2(2.2%)例患者發(fā)生植入金標移動,金標離腫瘤的距離超過3 cm,1例(1.1%)金標丟失致無法識別。1例(1.3%)患者出現(xiàn)嚴重并發(fā)癥,6例(7.8%)出現(xiàn)輕微并發(fā)癥。隨著金標的植入患者主訴在插入位點局部疼痛合并右腰部疼痛,筆者采取了鎮(zhèn)痛藥和保守治療,金標植入兩周后,進行立體定向放療CT定位掃描,患者沒有出現(xiàn)進一步的并發(fā)癥癥狀,2個被定位于腫瘤的金標一直完好。立體定向放療治療使腫瘤的大小1月內(nèi)從約2.0 cm減少至0.5 cm。6例(7.8%)有輕微并發(fā)癥的患者,住院過夜觀察,其中4例患者有腹痛,不需要特殊處理,2例患者有輕度發(fā)燒,也不需要特殊的處理。3例B超引導下通過直腸植入金標的患者中,1例患者出現(xiàn)一過性血尿,癥狀持續(xù)1d,為給予特殊處理;1例患者出現(xiàn)暫時性排尿困難。結論在B超下經(jīng)皮膚進行植入金標的并發(fā)癥相對較低,但仍要仔細考慮金標位置移動過大及金標丟失致無法識別。
[Abstract]:Objective to evaluate the safety and technical success rate of gold standard implantation in stereotactic radiotherapy. Methods A retrospective analysis of the clinical data of 77 patients with gold labeling was performed in 77 patients (including 48 livers, 26 pancreas, 12 prostate, 4 adrenal gland), and some complications occurred during and after the implantation. A gold-label implant capable of planning treatment and CT scanning was successfully performed. Results of the 90 gold labeling implants, 87 were successfully implanted and 3 needed to be re-implanted. The distance from the gold label to the tumor was more than 3 cm-1 in 1 case. The loss of gold label resulted in the loss of gold label in 1 case, which could not be recognized in 1 case (1.3%). Serious complications occurred in 6 cases (7. 8%). With the main complaint of local pain and right waist pain at the insertion site, the author took analgesic and conservative treatment. Two weeks after the implantation of gold label, CT scanning was performed for stereotactic radiotherapy. No further complications were noted, and two gold markers located in the tumor remained intact. Stereotactic radiotherapy reduced the size of the tumor from about 2 cm to 0. 5 cm.6 in one month. Patients with minor complications were observed overnight, 4 of whom had abdominal pain and 2 had mild fever without special treatment. There was also no need for special treatment in 3 cases of gold standard implanted through the rectum under the guidance of B-ultrasound. One patient developed transient hematuria and the symptoms lasted for 1 day. In order to give special treatment, one patient had temporary difficulty in urinating. Conclusion the complications of gold labeling implanted through skin under B-ultrasound are relatively low, but it is still necessary to carefully consider that the location of gold label is too large and the loss of gold label can not be recognized.
【作者單位】： 寧波市中醫(yī)院;寧波市第一醫(yī)院;南京醫(yī)科大學第一附屬醫(yī)院;
【分類號】：R730.55

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