恶性肿瘤现代微创或无创治疗的临床工作准则

Clinical Practice Guideline of Modern Microinvasive or Noninvasive Treatment for Malignant Tumours

目的 探讨恶性肿瘤现代微创或无创治疗的临床工作准则。方法 分析目前恶性肿瘤临床治疗的8种微创或无创治疗 (X 刀、γ 刀、粒子刀、中子刀、微波集束聚能刀、高能射频集束刀、超声聚焦刀、氩氦刀 )的基本特性与临床特征 ,结合临床经验及文献资料进行讨论。结果 ①恶性肿瘤现代微创或无创治疗技术可分为 3类 ,即射线束的毁损效应、高温消融效应、超低温冷冻消融效应。②具有对局部肿瘤能量高度集中、能量强度高的特点。③高能量集聚效应可高效性原位灭活或局部根治肿瘤 ,对人体损伤小 ,适应证较宽。④主要适用于肿瘤体积在一定范围而且形态较规则的肿瘤。结论 恶性肿瘤现代微创或无创治疗方法具有高科技、高效性杀灭肿瘤的特点 ,是肿瘤局部治疗的重要手段之一 ,对外科手术治疗形成挑战。恶性肿瘤微创或无创治疗应把握好综合治疗的时机。

Objective To evaluate clinical practice guideline of modern microinvasive or noninvasive treatment in human malignant carcinoma. Methods Analyse and discussion the basic characteristics and clinical feature combined with clinic and document about microinvasive or noninvasive treatiment of eight kinds (stereotactic radiation therapy, seeds knife, neutron knife, focused microwave coagulation, radio frequancy thermed ablation, high intensity focused ultrasound, Ar He cryoablation surgery). Results ① These treatment methods may be classnified into three sorts effects: Radiation coagulations and thermal ablation and cryoablation. ② There are charcteristic of high energy collection effect for local tumour. ③ Not only carcinoma may be eradicated as effective as operation, but also they minimally injury to human. ④ It is mainly suited to tumour of proper size and regular shape. Conclusion Modern microinvasive or noninvasive treatment methords are one of local ablation therapy for malignant carcinoma. It is give rise to challenge for surgery. Combining therapy are necessary for advanced carcinoma.\;