超声定位下经皮消融肾肿瘤的临床研究

Clinical research of percutaneous ablation in the treatment of kidney neoplasm with the assistance of ultrasonic location

目的:探索超声定位下微波、射频消融术治疗肾肿瘤的效果,寻找创伤最小并能保留肾单位的治疗肾肿瘤的新手段。方法:选择28例肾肿瘤患者(均为单发,肿瘤直径<4cm),消融治疗前行穿刺活检用来明确肿瘤性质。直径小于2.5cm的肿瘤患者行射频消融,2.5cm≤肿瘤直径<4cm的患者行微波消融治疗。然后对患者术后1月、3月、6月、12月、24月进行超声造影和CT造影复查。结果:所有患者术后均未见严重并发症,术后7天复查未见肿瘤残留,随访期内有2例肾癌患者复发而施行肾癌根治疗术。结论:对于不能耐受手术的肾恶性肿瘤患者,或者不愿意接受手术治疗的肾良性肿瘤患者而言,超声定位下经皮热消融治疗是一种创伤小、恢复快、相对安全的新型有效治疗方案。

Objective：To explore the therapeutic effect of microwave and radiofrequency ablation on treating the kidney neoplasm with the assistance of ultrasonic location and try to find out a new method which has the minimum trauma and can spare the nephron in treating kidney tumor.Methods：Selecting 28 patients with kidney tumor （all of them were solitary tumor,diameter ＜ 4cm）,aspiration biopsy was conducted on these patients before implementing the ablation treatment to make sure the character of the tumor.Those tumors,which diameter were smaller than 2.5cm received radiofrequency ablation and those greater than 2.5cm and smaller than 4cm received microwave ablation therapy.Then,carry out ultrasound contrast and CT radiography reexamination to patients after 1,3,6,12 and 24 months of the operation respectively.Results：All the patients havent shown obvious serious postoperative complication.No residual tumor had been found in recheck after 7 days of operation,while during the follow-up visit period,2 patients had relapse and received radical nephrectomy.Conclusion：With regard to those malignant renal tumor patients who cannot bear the operation,or to those benign renal tumor patients who are not willing to accept operative treatment,thermal ablation therapy under ultrasonic location is a new effective treatment which was shown as fewer traumas,rapid recuperation and relevant safer.