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目的 观察经皮肺穿刺氩氦靶向治疗肺转移癌的可行性和安全性。方法 采用CT引导下 ,经皮肺穿刺氩氦靶向治疗肺转移癌。结果 4 0例肺转移癌患者 80个病灶接受了氩氦刀治疗。 5 1个直径≤ 4cm肺内肿块 ,冰球覆盖肿瘤面积达 98 9% ,显效率可达 10 0 0 % ,而 2 9例直径 >4cm的肿块 ,冰球覆盖肿瘤面积达 87 0 % ,显效率达 86 2 % ,表明氩氦靶向治疗肺癌的局部疗效主要取决于肿块的大小。手术过程较安全 ,无 1例术中死亡。术后并发症较少 ,4 6 8%患者术后有少量咯血 ,2 5 8%有气胸 ,19 4 %有胸腔积液 ,19 4 %术后咳嗽加剧 ,16 1%有发热。术后 1周 6 7 7%的瘤体呈空洞样改变 ,体积增大 ;术后 1月瘤体缩小 ,11 1%病灶完全吸收 ,2 2 2 %还有空洞样改变。 3月后 ,瘤体进一步缩小 ,9 5 %的病灶 (<3cm)完成吸收。绝大多数密度变低 ,仅有 19%呈空洞样改变。 6月以后 ,瘤体变化不大。随访 15个月 ,中位生存期为 5个月。根据寿命表法计算 ,氩氦刀术后 6个月生存率为 6 6 % ,15个月为 5 0 %。结论 氩氦刀比较安全 ,疗效可靠。长期疗效有待进一步总结
Objective To observe the feasibility and safety of percutaneous pulmonary puncture with argon-helium in the treatment of lung metastases. Methods CT-guided percutaneous puncture of argon-helium targeted lung metastases. Results 40 patients with lung metastases were treated with argon-helium knife. 5 lumps with a diameter less than 4cm were covered with ice hockey. The area covered by ice hockey was 98.9% and the effective rate was 100%. While 29 cases with a diameter> 4cm were covered with ice hockey, the effective area was 87.0% 86 2%, indicating that the target effect of argon-helium targeted therapy on lung cancer mainly depends on the size of the tumor. Surgical procedures safer, no one case of intraoperative death. There were fewer postoperative complications. A small amount of hemoptysis was found in 468% of the patients, with pneumothorax in 258%, pleural effusion in 19%, postoperative cough in 19.4% and fever in 16%. One week after operation, 67.7% of the tumors showed vacuolar changes and increased in volume. The tumors were reduced in 1 month after operation, completely absorbed in 11.1% of the lesions, and remained unchanged in 22.2%. After 3 months, the tumor was further reduced and 95% of the lesions (<3 cm) completed the absorption. The vast majority of the density became lower, with only 19% showing a void-like change. After June, the tumor did not change much. Followed up for 15 months, the median survival was 5 months. According to the life table method, the survival rate of 6 months after argon-helium knife surgery was 6 6% and that of 15 months was 50%. Conclusion argon helium knife safer, reliable. Long-term efficacy remains to be further summarized