[Clinical application of CT-guided radiofrequency ablation combined with biopsy synchronously to multiple small nodules of lung metastatic tumors].
[Clinical application of CT-guided radiofrequency ablation combined with biopsy synchronously to multiple small nodules of lung metastatic tumors].
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DOI：
10.3760/cma.j.issn.0376-2491.2018.27.013
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发表时间：
2018-07-17
影响因子：
--
通讯作者：
Xiao, Y Y
中科院分区：
文献类型：
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作者：
Li, W;He, X F;Xiao, Y Y
目的：目的探讨CT引导下射频消融（RFA）联合同步活检治疗肺多发小结节转移瘤的疗效和安全性。方法：2016年1月至2016年12月，解放军总医院共86例患者，144个病灶，分为两组（所有病灶均小于1 cm）。A组51例位于肺周围，先活检后行RFA，B组35例位于肺中、内侧，邻近血管先行RFA，随访1 ~ 12个月。结果如下：所有手术均顺利完成，术中CT扫描显示消融区分别被指示性“晕征”完全覆盖，A、B两组在结节数、病理结果阳性率和并发症的等级和检查上的P值分别为0.818、0.155和0.452，均高于0.05。尽管根据淋巴结的不同位置采取不同的策略，但两组均能达到安全有效的治疗。两组患者术后1个月CT均显示高密度消融区，无增强。术后3个月和6个月CT显示病灶减少，术后12个月CT显示病变变为纤维条纹。结论：CT引导下射频消融联合活检对肺内多发小结节转移瘤安全有效，对于位于肺中部或内侧的病灶，活检前射频消融可避免大咯血的发生。
Objective: To investigate the therapeutic efficacy and safety of CT-guided radiofrequency ablation(RFA)combined with biopsy synchronously to multiple small nodules of metastatic tumors in lung. Method: From January 2016 to December 2016, a total of 86 patients in the General Hospital of People's Liberation Army with 144 lesions were divide into two groups(all the lesions were less than 1 cm). Group A with 51 cases located in the lung periphery underwent biopsy prior to RFA.Group B with 35 cases located in the middle and inner side of lung adjacent to the vasculatures contrarily underwent RFA first.The changes of these lesions during the 1 to 12-month were followed up. Results: All the procedures were completed successfully.The intra operative CT scanning showed the ablation zones were completely covered by the indicative "halo sign" respectively.The P value was 0.818, 0.155 and 0.452 respectively, in the number of nodules, pathological results positive rate and complications in the rank and inspection for A, B two groups, which were all higher than 0.05.Though different strategies according to different location of the nodes, the two groups can achieve safe and effective treatments.All patients in two groups had high density ablation zones on their 1-month post operative CT without enhancement.3-and 6-post operative CT illustrated a decrease of lesions, 12-month post operative CT showed the lesions turned to fibrous stripes. Conclusion: The CT-guided RFA combined with biopsy synchronously to multiple small nodules of metastatic tumors in lung is safe and effective, for the lesions located in the middle or inner side of lung, RFA prior to the biopsy can avoid the massive hemoptysis.