微波消融近支气管处肺肿瘤的气管壁热损伤研究

Study on Tracheal Wall Thermal Injury of Lung Tumor Near Bronchus by Microwave Ablation

目的模拟近支气管处肺肿瘤行60 W、300 s微波消融术的情形,对可能造成的支气管壁损伤区域予以界定,为临床安全治疗提供数据支持。方法基于气体流动条件(呼吸速率为1.0 m/s)和生理参数(肿瘤直径为1 cm),建立含有三级支气管分支的肺模型和肿瘤不同位置模型;通过电磁场-温度场-流场耦合进行有限元分析,研究在肿瘤完全消融时气管壁受到损伤的体积。结果肿瘤边缘距离主支气管、第二级支气管分别超出5和4 mm时,行微波消融术安全有效,气管壁无损;临近第三级支气管时,距离达2.1 mm以上即为安全治疗范围,无损伤风险。结论微波消融肺肿瘤临近支气管这一关键部位时,气管壁受损程度和消融安全范围与肿瘤中心位置相关。

Objective To simulate the 60 W,300 s microwave ablation of lung tumor near the bronchus,to define the possible area of bronchial wall injury so as to provide data support for clinical safety treatment.Methods Based on the airflow conditions(respiratory rate of 1.0 m/s)and physiological parameters(tumor diameter of 1 cm),the lung model with three-stage bronchial branches and the different position models of the tumor were established,and the finite element analysis of electromagnetic field-temperature field-flow field coupling was carried out to study the volume of the tracheal wall injured under the premise of complete ablation of the tumor.Results Microwave ablation was safe and effective when the distance of the primary and secondary bronchi exceeded 5 and 4 mm respectively,and the tracheal wall was intact.When the distance was above 2.1 mm near the tertiary bronchus,it was safe to treat and there was no risk of injury.Conclusion When microwave ablation of lung tumor is adjacent to the bronchus,the degree of wall injury and the safe range of ablation are related to the central location of the tumor.