模拟定位机引导下经皮穿刺集束巨能刀射频治疗肺癌的临床应用

为了探讨局部麻醉和模拟定位机引导在集束巨能刀治疗肺癌的射频治疗的适应证、治疗效果以及并发症的预防和处理,采用0·5%普鲁卡因局部浸润麻醉,模拟定位机引导下经皮穿刺集束巨能刀治疗肺癌46例。CT显示条索状瘢痕残余11例,空洞形成或直径缩小32例,无变化1例,增大2例。治疗中患者均有不同程度的胸腔内热感及短时间内可以忍受的疼痛感。并发症包括气胸7例、皮下气肿5例、发热24例、咯血13例和慢性支气管炎急性发作4例。初步研究结果提示,集束巨能刀射频治疗周围型肺癌疗效满意,尤其适用于直径<3cm的肿瘤。局部麻醉配合全身止痛药物应用可以很好地解决治疗中的疼痛问题,与全麻相比还具有省时省力、费用低的优势;对于周围型肺癌,模拟定位机引导经皮穿刺定位与CT引导相比,同样准确、安全,但操作更为方便。

Radiofrequency ablation of lung malignancies using percutaneous assembly-energy scalpel under local anesthesia and analogue-localization

To study the adaption, therapeutic efficacy, prevention and management of various complications of Assembly-Energy Scalpel in the treatment of lung malignancies and the feasibility of local anesthesia and ananlogue-localization guide in this technique. 46 cases of lung cancer were treated via percutaneous Assembly-Energy Scalpel under local anesthesia and analogue-localization guide. CT scan shows that tumour disappeared with trabs-like residue in 11 cases, internal cystic change or diameter-reduction of tumours occured in 32 cases,no change in 1 case and diameter-enlargement in 2 cases. Complications include 4 cases of pneumothorax, 3 cases of subcutaneous emphysema, 18 cases of Fever, 9 cases of hemoptysis and 3 cases of acute onset of chornic bronchitis. There's no severe pain,hemothorax and local infection occured. The effect of Assembly-Energy Scalpel radiofrequency ablation guided by analogue-localization is affirmative in the treatment of lung malignances, especially in the treatment of peripheral lung tumours which diameter is less than 3 cm. Local anesthesia is a easy method to deal with the theraputic pain, and, ananlogue-localization guide is a reliable localizing method with high security and precision for peripheral tumours.