【作者】 王刚； 孙尧； 丛林； 荆雪虹； ZHANG Jing-zhu；

【Author】 WANG Gang;SUN Yao;CONG Lin;JING Xue-hong;ZHANG Jing-zhu;

【机构】 山东省医学影像学研究所超声介入研究室；

【摘要】 目的评估人工胸水在超声引导经皮微波消融治疗靠近膈肌肝脏肿瘤的可行性、安全性及有效性。方法11例肝肿瘤患者共14个靠近膈肌常规超声检查显示欠清晰的肝脏肿瘤拟行超声引导经皮微波消融,术前右侧胸腔注入人工胸水,观察人工胸水操作成功率、注入后是否达到预期效果、并发症及消融的局部疗效。结果人工胸水操作成功率为100%,一般操作过程需35～40min,注入人工胸水量1000～1500ml,靠近膈肌因肺遮挡超声无法清楚显示或显示不全的病灶均能清楚显示,肿瘤完全消融率达92.9%,未发生严重并发症。结论人工胸水使位于超声盲区无法进行热消融的肝穹隆部肿瘤清楚显示,为部分病例提供新的安全穿刺路径,拓宽了消融治疗适应证,使部分困难病例获得了治疗机会。人工胸水安全可行,值得临床进推广应用。更多还原

【Abstract】 Objective To assess the feasibility,safety and availability of artificial hydrothorax in ultrasoundguided microwave ablation procedure.Methods Artificial hydrothorax,was performed in 11 difficult cases(14 lesions) which could not be completely revealed in ultrasound before percutaneous ultrasound-guided microwave ablation procedures.The technical success rate,the rate of approaching the procedure goal,complications,and local treatment response were assessed.Results The artificial hydrothorax technical success rate was 100%.The duration of instilling is 35-40 minutes and 1000 ~ 1500 ml.All the lesions were clearly revealed after induction of artificial hydrothorax which were adjacent to the diaphragm and could not be completely revealed before;got a safe puncture path after instilling.The completely ablation rate was92.9%and no severe complications occurred.Conclusions The use of artificial hydrothorax significantly improves the visibility of some tumors adjacent to the diaphragm where tumors were previously inappropriate for ultrasoundguided microwave ablation and provides a safe puncture path for some patients.Therefore,it expands the indications of microwave ablation and offers opportunities of treatment for some difficult cases.Artificial hydrothorax are safe,feasible,which should be spreadand used in large clinical population.更多还原