超声引导下经皮穿刺肝脏金标植入临床分析

Clinical analysis of percutaneous puncture golden marker implant into liver guided by ultrasound

目的：总结金标追踪法射波刀治疗肝脏肿瘤时，在超声引导下经皮穿刺植入纯金标记物的经验。方法：搜集2012年11月至2014年11月射波刀治疗肝脏肿瘤行金标追踪靶区的患者62例。局部麻醉、超声引导，在穿刺的针道上采用退针法由远及近放置金粒子2枚，共4～6枚。金粒子分布在肿瘤周边尽量不经过肿瘤，彼此间距离2～6cm，避开大的血管与胆管。结果：62位患者共植入金粒子254枚（其中3位患者各植入6枚），操作期间发现肝内沿针道出血4处，出血量1～4ml，止血治疗观察3h出血未增加。结论：超声引导下肝脏金粒子植入操作简单、快捷，患者痛苦小、创伤轻微，是一种安全、准确、有效的方法。

Objective To evaluate the safety and complications of ultrasound-guided implantation of intrahepatic fiducial markers before the liver tumors are treated with CyberKnife. Methods Totally 62 patients undergoing percutaneous fiducial marker implantations for primary hepatic tumors from November 2012 through November 2014 were collected as the subjects. Guided by ultrasound, two gold markers were placed along the route of puncture from far to near, with a total of 4 to 6 markers distributed in every procedure. The distance between each other was from 2 to 6 cm, with large blood vessels and bile ducts avoided as far as possible. Results The 62 patients had a total of 254 golden markers implanted into the livers, three of whom had six golden markers implanted each time. Four patients were found with intrahepatic hemorrhage along the route of needle during operation, and the volume of bleeding was only l to 4 ml. Bleeding was not increased through hemostatic treatment after 3-hour observation. Conchuslon Ultrasound-guided liver golden marker implantation is easy, safe and slightly invasive. [Chinese Medical Equipment Journal, 2015,36（12） ： 83-85]