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

【摘要】：目的評(píng)估在立體定向放療中B超下植入金標(biāo)的安全性和技術(shù)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(biāo)90個(gè)(其中48個(gè)肝臟,26個(gè)胰腺,12個(gè)前列腺,4個(gè)腎上腺);金標(biāo)植入過(guò)程中及植入完成后患者出現(xiàn)了一些相關(guān)并發(fā)癥;能夠進(jìn)行治療計(jì)劃及CT掃描的金標(biāo)植入為技術(shù)成功。結(jié)果90個(gè)金標(biāo)的植入中,87個(gè)(96.7%)植入成功,3例需要重新進(jìn)行金標(biāo)的植入。其中2(2.2%)例患者發(fā)生植入金標(biāo)移動(dòng),金標(biāo)離腫瘤的距離超過(guò)3 cm,1例(1.1%)金標(biāo)丟失致無(wú)法識(shí)別。1例(1.3%)患者出現(xiàn)嚴(yán)重并發(fā)癥,6例(7.8%)出現(xiàn)輕微并發(fā)癥。隨著金標(biāo)的植入患者主訴在插入位點(diǎn)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(biāo)植入兩周后,進(jìn)行立體定向放療CT定位掃描,患者沒(méi)有出現(xiàn)進(jìn)一步的并發(fā)癥癥狀,2個(gè)被定位于腫瘤的金標(biāo)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(guò)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(dǎo)下通過(guò)直腸植入金標(biāo)的患者中,1例患者出現(xiàn)一過(guò)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(shí)性排尿困難。結(jié)論在B超下經(jīng)皮膚進(jìn)行植入金標(biāo)的并發(fā)癥相對(duì)較低,但仍要仔細(xì)考慮金標(biāo)位置移動(dòng)過(guò)大及金標(biāo)丟失致無(wú)法識(shí)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(xué)第一附屬醫(yī)院;
【分類號(hào)】：R730.55

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