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CT引导下射频消融治疗肺癌的学习曲线 被引量:5

Learning Curve of CT-guided Percutaneous Radiofrequency Ablation in the Treatment of Lung Cancer
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摘要 目的探讨CT引导下射频消融治疗不能手术原发性肺癌的学习曲线。方法收集2007年3月~2009年6月90例不能手术的肺癌患者临床资料和CT引导下射频消融治疗结果,所有患者由射频消融研究组完成,按照时间顺序分为3组(A、B和C组,每组30例)。A组在14个月内完成,平均每月2.1例;B组在7个月内完成,平均每月4.3例;C组在6个月内完成,平均每月5.0例。3组性别、年龄、体力状况(ECOG)评分、病灶大小、消融灶数量、位置等无统计学差异(P>0.05)。比较3组的操作时间、射频消融时间、病灶定位时间、并发症发生率、术后住院时间和完全消融率等。结果 C组操作时间(42.0±13.3)min明显短于A组(53.7±16.7)min和B组(60.5±26.5)min(F=6.821,P=0.002,PA-B=0.182,PA-C=0.024,PB-C=0.000);C组的射频针在肿瘤内的定位时间(5.5±1.3)min明显短于A组(13.2±4.0)min和B组(11.4±5.7)min(F=28.867,P=0.000,PA-B=0.095,PA-C=0.000,PB-C=0.000);术后住院时间B组(2.5±0.8)d和C组(2.4±1.6)d明显短于A组(3.2±0.8)d(F=4.646,P=0.012,PA-B=0.024,PA-C=0.005,PB-C=0.566)。3组间肿瘤完全消融率和并发症无统计学差异(P>0.05)。结论 CT射频消融治疗不能手术肺癌存在学习曲线的问题,经过60例的经验积累,会缩短射频消融的操作时间和住院时间。 Objective To evaluate the learning curve of CT-guided pereutaneous radiofrequency ablation (RFA) for inoperable lung cancer. Methods The clinical data and treatment outcomes of 90 patients undergoing percutaneous RFA procedures for inoperable primary lung cancer were collected prospectively between March 2007 and June 2009. All the patients were managed by a single team of surgeons. The patients were divided into 3 groups (groups A, B and C with 30 in each) according to the date of theoperation. In group A, the 30 cases of RFA was completed within 14 months (2. 1 cases per month on average) , while that was 7 months in group B (4.3 cases per months), and 6 months in group C (5.0 cases per months). There were no significant differences among the groups with respect to sex, age, ECOG score, pathologic type, tumor size and tumor location (P 〉 0. 05) . The time for the procedure and radiofrequency ablation, and tumor puncture, morbidity, hospital stay, and complete ablative rate were retrospectivecompared among the three groups. Results The time for the procedure in group C was (42.0±13.3) min, which was significantly shorter than that in groupsA and B [(53.7±16.7) min and (60.5±26.5) min; F=6.821, P=0.002, PA-B=0.182, PA-C = 0. 024, PB - C= 0. 000 ] ; the time of tumor puncture in group C was (5.5:1:1.3 ) min, which was also significantly shorter than that in groups A andB [(13.2±4.0) rain and (11.4±5.7) min; F=28.867, P=0.000, PA-B =0.095, PA-C =0.000, PB-C=0. 000]. The hospital stay in groups B and C was (2.5 +0.8) and (2.4 ±1.6) days respectively, both were significantly shorter than that in group A [ ( 3.2±0.8 ) d ; F = 4. 646, P = 0. 012, PA-B= 0. 024, PA-C= 0. 005, PB-C=O. 566 ]. No significant difference in complete ablative rate and overall morbidity was observed among the three groups. Conclusions There is a significant learning curve in RFA for inoperable lung cancer. Shorter hospital stay and operation time can be achieved with the accumulated experience after the first 60 cases by a specialized team.
出处 《中国微创外科杂志》 CSCD 2012年第2期160-163,共4页 Chinese Journal of Minimally Invasive Surgery
关键词 肺肿瘤 射频消融 学习曲线 体层摄影术 X线计算机 引导 Lung neoplasms Radiofrequency ablation Learning curve Tomography, X-ray computed Guidance
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参考文献12

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共引文献71

同被引文献40

  • 1刘宝东,刘磊,胡牧,钱坤,李元博,王若天,支修益.CT引导下射频消融治疗肺内特殊部位恶性肿瘤的临床评价[J].结核病与肺部健康杂志,2013,2(1). 被引量:6
  • 2张智坚,吴孟超,陈汉.射频消融肝脏恶性肿瘤并发症的防治[J].中国微创外科杂志,2005,5(2):113-115. 被引量:11
  • 3马宽生.肝脏良性肿瘤的射频消融治疗[J].中国微创外科杂志,2006,6(1):11-12. 被引量:8
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  • 6Junichi Soh,Shinichi Toyooka,Hideo Gobara,Takao Hiraki,Seiichiro Sugimoto,Masaomi Yamane,Takahiro Oto,Susumu Kanazawa,Shinichiro Miyoshi.A Case of Delayed Massive Hemothorax Caused by the Rupture of a Pulmonary Artery Pseudoaneurysm after Radiofrequency Ablation of Lung Tumors[J].Japanese Journal of Clinical Oncology.2012(7)
  • 7Takao Hiraki,Hideo Gobara,Kentaro Shibamoto,Hidefumi Mimura,Yuko Soda,Mayu Uka,Yoshihisa Masaoka,Shinichi Toyooka,Susumu Kanazawa.Technique for Creation of Artificial Pneumothorax for Pain Relief during Radiofrequency Ablation of Peripheral Lung Tumors: Report of Seven Cases[J].Journal of Vascular and Interventional Radiology.2011(4)
  • 8Victoria O. Chan,Shaunagh McDermott,Dermot E. Malone,Jonathan D. Dodd.Percutaneous Radiofrequency Ablation of Lung Tumors: Evaluation of the Literature Using Evidence-based Techniques[J].Journal of Thoracic Imaging.2011(1)
  • 9Aude Jeannin,Pierre Saignac,Jean Palussière,Jean-Pierre Gékière,Edouard Descat,Fabrice Lakdja.Massive Systemic Air Embolism During Percutaneous Radiofrequency Ablation of a Primary Lung Tumor[J].Anesthesia & Analgesia.2009(2)
  • 10Edward W. Lee,Robert D. Suh,Michelle R. Zeidler,Irene S. Tsai,Robert B. Cameron,Fereidoun G. Abtin,Jonathan G. Goldin.Radiofrequency Ablation of Subpleural Lung Malignancy: Reduced Pain Using an Artificially Created Pneumothorax[J].CardioVascular and Interventional Radiology.2009(4)

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