【摘要】 目的评估超声引导下纳米刀治疗危险部位恶性肿瘤的安全性和有效性。方法回顾性分析23例经超声引导下纳米刀治疗的危险部位恶性肿瘤的术前术后资料,通过观察术中、术后并发症情况评估纳米刀消融安全性;通过观察术后症状缓解情况和术后1个月短期疗效评估纳米刀消融有效性。结果恶性肿瘤分布于胰腺、腹膜后、肝脏及颌面部,例数分别为16(69.5%)、3(13.1%)、2(8.7%)、2(8.7%)例,肿瘤平均大小(3.5±1.2)cm;采用开腹、经皮、经口底超声引导下消融的病例数分别为20(87.0%)、2(8.7%)、1(4.3%)例;所有患者均顺利完成纳米刀消融,6例(26.1%)患者出现术中不良反应,包括1例(4.3%)心率、血压持续波动和5例(21.7%)一过性血压升高;术后不良反应及并发症,包括低位不完全性肠梗阻1例(4.3%),胃排空障碍4例(17.4%),室上性心动过速、高血压、心律不齐等心血管并发症3例(13.0%),所有患者均治愈出院;93.3%以疼痛就诊患者术后一周疼痛缓解,术后1个月增强影像学显示消融灶范围大于术前肿瘤范围,消融灶内见无增强区,53.8%胰腺癌患者肿瘤标记物较术前降低。结论超声引导下纳米刀治疗危险部位恶性肿瘤是安全和有效的,但其远期疗效以及消融术后的影像学评估仍有待下一步深入研究。更多还原

【Abstract】 Objective To evaluate the short-term effect and safety of ultrasound guided irreversible electroporation(IRE)in the treatment of malignant tumor in dangerous position.Methods Twenty-three malignant tumors in dangerous position were treated by IRE under ultrasound guidance.Clinical data before and after ablation was retrospectively analyzed.Safety of IRE procedure was evaluated by analyzing the perioperative complication;CT images and serum tumor marker were analyzed to evaluate the treatment effect.Results Malignant tumors enrolled in this study including 16(69.5%)pancreatic malignant tumors,3(13.1%)retroperitoneal malignant tumor,2(8.7%)primary liver carcinoma and 2(8.7%)malignant tumors in maxillofacial region.All patients were successfully treated with IRE ablation.Six(26.1%)complication were described during ablation including five(21.7%)transient hypertension and one(4.3%)continuous fluctuation of blood pressure.Eight(34.8%)postoperative complication were observed including one(4.3%)lower gastrointestinal obstruction,4(17.4%)delayed gastric empty and 3(13.0%)cardiovascular complication.The pain remission rate was 93.3%in pain-suffered patients;lower serum tumor marker level was observed in 53.8% patients one month after ablation.Conclusions IRE is a safe and promising procedure in the management of malignant tumors located in dangerous position.更多还原