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目的 观察经皮穿刺氩氦靶向治疗肺癌的安全性和可行性。方法 2 37例肺癌患者采用计算机体层摄影术引导下经皮穿刺氩氦靶向治疗 2 78次 ,治疗病灶 30 7个。术中用多功能心电监护仪监测心率、血压等的变化 ;术后 5～ 10min再次计算机体层摄影术扫描 ,以观察冰球大小及有无气胸等并发症。术后不同时间分别复查计算机体层摄影术扫描、正电子发射扫描及经皮肺穿刺活检等 ,动态观察肿瘤的变化。结果 12 4个病灶肺内肿块直径≤ 4cm者冰球覆盖肿瘤面积达 96 7% ,显效率可达 97 1% ;183个病灶肿块直径 >4cm者冰球覆盖肿瘤面积达 79 6 % ,显效率达 6 0 7% ,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 ,仅有约 2 5 9%的患者有一过性轻度血压升高 ,无 1例术中死亡 ;术后并发症较少 ,仅38 1%患者少量咯血 ,35 3%发热 ,2 9 1%气胸和 6 1%胸腔积液等。术后 1周左右肿瘤增大 ,约 3/ 4可见空洞形成 ,正电子发射扫描亦显示肿瘤中央呈环状改变。术后 1月左右瘤体变小 ,部分缓解 +完全缓解达6 4 % ,空洞减少 (占 38% ) ,正电子发射扫描显示瘤体异常放射性聚集减少 ,靶 /本比值降低。 3月左右 ,部分缓解 +完全缓解达 6 1.4 % ,空洞更趋减少 (仅 2 1% )。 6～ 12月部分缓解 +完全缓解仍达
Objective To observe the safety and feasibility of targeted percutaneous argon-helium lung cancer treatment. Methods Twenty-seven patients with lung cancer underwent computed tomography guided percutaneous argon-helium targeted therapy for 2 78 times and treated 307 lesions. Intraoperative monitoring of heart rate, blood pressure and other changes with a multi-function ECG monitor; postoperative 5 ~ 10min again computed tomography scan to observe the size of the ice hockey with or without complications such as pneumothorax. At different times after surgery, computer tomography scanning, positron emission tomography and percutaneous lung biopsy were respectively reviewed to observe the changes of the tumor. Results 12 4 lesions with a diameter of less than 4 cm in the lung were covered with 96.7% of the ice hockey, the effective rate was 97.1%. The diameter of the tumor with a diameter of 4 cm in 183 lesions was 79.6%, and the effective rate was 6% 0 7%, indicating that the local efficacy of argon-helium targeted therapy of lung cancer mainly depends on the size of the tumor. Surgical procedure is safer, only about 259% of patients had transient mild hypertension with no intraoperative death; fewer postoperative complications, only a small amount of hemoptysis in 38 1%, 35 3% fever, 2 9 1% pneumothorax and 6 1% pleural effusion and so on. About 1 week after surgery, the tumor increased, about 3/4 visible cavity formation, positron emission tomography also showed a central annular tumor changes. After 1 month or so, the tumor size became smaller, the partial response + complete remission reached 64% and the cavity decreased (38%). The positron emission tomography showed that the abnormal radioactive aggregation of the tumor decreased and the target / ratio decreased. In March, partial relief + complete relief reached 6 1.4% and vacancies tended to decrease (only 21%). 6 ~ December partial remission + complete remission is still up