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目的探讨CT导向下经皮肺穿刺射频消融治疗肺部肿瘤的有效性、安全性及并发症。方法对不能手术的74例原发肺癌(其中鳞癌23例,腺癌48例,鳞腺癌2例,大细胞癌1例)和14例转移性肺癌共96个病灶(其中最大直径≤3 cm31个,3~5 cm 56个,>5 cm 9个),在CT导向下行射频消融治疗,术后6个月随访评价疗效。结果 88例患者共行134次射频消融治疗,除1例术中癫痫发作中断手术而行二期射频消融治疗外,其余均顺利完成。术后6个月行CT复查,显示96个病灶体积中88个均进行性缩小,肿瘤内大片不规则低密度区,总有效率为91.7%。1年随访有效率为88.0%,1年无疾病进展生存率为95.5%。气胸发生率为7.9%。结论 CT导向下经皮肺穿刺射频消融治疗肺部肿瘤安全、有效,并发症较少,对不同肿瘤采取科学的射频消融治疗方案可取得较好的疗效。
Objective To investigate the efficacy, safety and complications of radiofrequency catheter ablation for lung tumors under CT guidance. Methods Totally 96 unrelated patients with primary lung cancer (23 squamous cell carcinoma, 48 adenocarcinoma, 2 adenocarcinoma, 1 large cell carcinoma) and 14 metastatic lung carcinomas (of which the largest diameter ≤3 cm31, 3 ~ 5 cm 56,> 5 cm 9). CT guided radiofrequency catheter ablation and follow-up 6 months after operation were used to evaluate the curative effect. Results A total of 134 radiofrequency ablation procedures were performed in 88 patients. All patients underwent radiofrequency catheter ablation except for one intraoperative epileptic seizure. All the others were successfully completed. Sixty-six months after operation, CT examination showed that 88 of 96 lesion sizes were progressively reduced, and the total effective rate was 91.7%. One-year follow-up efficiency was 88.0%, 1 year disease-free survival rate was 95.5%. Pneumothorax incidence was 7.9%. Conclusion CT guided percutaneous radiofrequency ablation of lung tumors safe and effective, with fewer complications, for different tumors to take a scientific radiofrequency ablation treatment program can achieve better results.