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探讨冷冻消融术在盆腔转移性肿瘤中的应用及效果。术中直视下或在CT引导下经皮穿刺氩氦靶向冷冻消融。结果表明30例中术后CT显示25例瘤体未完全冷冻灭活,5例完全冷冻灭活,随访最短4月,最长39月。1年生存率80%(24/30),3年生存率13.3%(4/30)。其中5例完全性冷冻者,1年生存率100%(5/5),3年生存率80%(4/5);不完全性冷冻者最长生存22月。完全性冷冻者术后经CT增强扫描,动脉造影显示肿瘤区为一低密度区和无血管区,1月后肿瘤坏死区逐渐吸收缩小,5~6月后完全吸收形成纤维化疤痕点。不完全性冷冻25例中冷冻范围达70%以上者19例,冷冻范围达50%左右者6例。术后发热反应3~10天,为肿瘤吸收热;会阴部皮肤冻伤1例,臀部化脓2例。骶尾部转移瘤冷冻后一过性大小便失禁2例。难治性盆腔转移瘤氩氦靶向冷冻消融术为一种安全、有效的肿瘤消融手段,若能完全冷冻灭活局限性肿瘤组织可显著提高生存率。不完全性冷冻范围大于70%以上者,临床症状明显改善。
To investigate the application and effect of cryoablation in pelvic metastatic tumors. Surgery under direct vision or CT-guided percutaneous argon-helium cryoablation targeted. The results showed that 30 cases of postoperative CT showed that 25 cases of tumor was not completely frozen inactivation, 5 cases completely frozen inactivation, the shortest follow-up in April, the longest 39 months. The 1-year survival rate was 80% (24/30) and the 3-year survival rate was 13.3% (4/30). Among them, 5 cases were completely frozen, one-year survival rate was 100% (5/5), 3-year survival rate was 80% (4/5); incomplete freezing the longest survival in 22 months. Complete reconstructive surgery by CT enhanced scanning, angiography showed a low-density tumor area and no vascular area, after 1 month of tumor necrosis gradually reduced, 5 to 6 months after the complete absorption of the formation of fibrosis scar point. Incomplete freezing 25 cases, the freezing range of more than 70% in 19 cases, the freezing range of about 50% in 6 cases. Postoperative fever 3 to 10 days for the tumor heat absorption; perineal skin frostbite in 1 case, 2 cases of hip suppuration. Sacrococcygeal metastasis Frozen incontinence after transient incontinence in 2 cases. Refractory pelvic metastases Argon-helium targeted cryoablation is a safe and effective means of tumor ablation, if the complete freezing inactivation of localized tumor tissue can significantly improve the survival rate. Incomplete freezing range greater than 70%, clinical symptoms improved significantly.