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目的超声造影监测下尝试应用射频消融联合微波热消融治疗1例淋巴结黑素瘤,观察其疗效。方法受治者为64岁男性右足底黑素瘤患者,首发症状为右腹股沟淋巴结肿大,9个月内先后2次行手术切除。随后的2~7个月间于右侧髂动脉旁和右下肢相继出现20余枚肿大的淋巴结,合并右下肢肿胀。鉴于淋巴结包绕髂动脉、数目甚众故不考虑外科手术,且应用化疗及中药治疗效果不明显,遂在超声造影监测下联合使用CelonLab-ENT单针双极射频消融仪和YWY-2T微波消融仪对转移淋巴结进行热凝固治疗,术后观察疗效并进行随访。结果术中、术后超声造影及穿刺病理检查证实所有经治淋巴结均丧失血供,凝固性坏死、萎缩,无明显并发症。患者一般情况良好,除右下肢少数转移淋巴结病灶仍接受热消融治疗外,其他各处均未再发现病灶。结论超声造影监测下射频和微波热消融治疗本例淋巴结黑素瘤取得了稳定的杀灭肿瘤效果,治疗过程未发现明显并发症,可以考虑在临床上推广使用。
Objective To evaluate the efficacy of radiofrequency ablation combined with microwave ablation in the treatment of one case of lymph node melanoma under ultrasound contrast monitoring. Methods The subjects were 64-year-old male patients with right-sided melanoma. The first symptom was the right inguinal lymph node enlargement. Surgical resection was performed twice within 9 months. Followed by 2 to 7 months in the right iliac artery and right lower limb have appeared more than 20 enlarged lymph nodes, combined with right lower limb swelling. In view of lymph nodes around the iliac artery, the number of so many people do not consider surgery, and the application of chemotherapy and traditional Chinese medicine treatment effect is not obvious, then under ultrasound contrast combined with CelonLab-ENT single needle bipolar radiofrequency ablation and YWY-2T microwave ablation Instrument for metastatic lymph nodes for thermal coagulation therapy, postoperative efficacy and follow-up. Results Intraoperative and postoperative ultrasonography and biopsy confirmed that all the treated lymph nodes lost blood supply, coagulation necrosis, atrophy and no obvious complications. Patients generally good, except for a small number of right lower extremity lymph node metastases are still undergoing thermal ablation treatment, no other lesions were found elsewhere. Conclusion The radiofrequency ablation and microwave ablation in this case of lymphoma melanoma achieved stable anti-tumor effect in this case. No obvious complications were found in the course of treatment, which could be considered for clinical application.