HRCT引导下射频消融治疗早期非小细胞肺癌的并发症

Complications of HRCT-Guided Radiofrequency Ablation in Treatment of Early Non-Small Cell Lung Cancer

目的研究高分辨率CT引导下射频消融(RFA)治疗早期非小细胞肺癌(NSCLC)的并发症发生率及其相关风险因素分析。方法搜集河南省胸科医院的80例Ⅰ期NSCLC患者的临床资料,均采用CT引导下RFA治疗,并具有规范的随访记录。对本组患者死亡率及治疗相关的并发症进行数据分析,以确定并发症的发生率与性别、年龄、肿瘤大小、数目、类型及消融时间、次数是否相关。结果对80例Ⅰ期NSCLC患者(共86个病灶)进行评估,共进行88次RFA。男54例,女26例,年龄48~85岁,平均(65.4±7.2)岁。肿块最长径0.42~3.00 cm,平均(2.34±0.61)cm。随访至2020年8月,共16例患者死亡(14例死于肿瘤进展,2例死于肺部感染)。发生治疗相关的并发症共23例(28.75%),其中气胸6例(7.50%)、胸腔积液4例(5.00%)、咯血8例(10.00%)、肺炎5例(6.25%)。单因素分析结果表明,性别、肿瘤直径及类型是治疗相关并发症发生的风险因素(P<0.05);多因素分析结果表明,仅肿瘤类型是治疗相关并发症发生的独立风险因素(P<0.05)。结论结果表明HRCT引导下射频消融治疗Ⅰ期NSCLC是一项安全、微创、并发症发生率低的方法。

Objective To investigate the incidence and risk factors of complications in the treatment of early non-small cell lung cancer(NSCLC)by radiofrequency ablation guided by thin slice high resolution CT.Methods This study was a retrospective study,allsubjects who were treated with CT-guided radiofrequency ablation and had standard follow-up records.For 80 patients with stage I NSCLC admitted to Henan Chest Hospital withinaperiod of 3 years,the clinical data,mortality and treatment-related complications were recorded,and then the data was analyzed to determine whether the incidence of complications was related to gender,age,tumorsize,number,type,ablation time and frequency.Results Eighty patients with stage I NSCLC(a total of 86 lesions)were evaluated,and a total of 88 RFA were performed.There were 54 males and 26 females,aged 48~85 years old,with an average age of(65.4±7.2)years old.The longest diameter of the mass was 0.42~3.00 cm,with an average diameter of(2.34±0.61)cm.During follow-up up to August 2020,a total of 16 patients died(14 died from tumor progression and 2 died from pulmonary infection).There were 23 cases(28.75%)of treatmentrelated complications:pneumothorax in 6 cases(7.50%),pleural effusion in 4 cases(5.00%),hemoptysis in 8 cases(10.00%),pneumonia in 5 cases(6.25%).Univariate analysis showed that gender,tumor diameter and type were adverse risk factors for the occurrence of treatment-related complications(P<0.05),while multivariate analysis showed that only tumor type was the independent risk factor for the occurrence of treatment-related complications(P<0.05).Conclusion Results showed that HRCT guided radiofrequency ablation is a safe and minimally invasive treatment of stageⅠNSCLC,with a low complication rate.