穿刺活检联合微波消融治疗高龄患者肺单发恶性倾向小结节

目的观察CT引导下经皮穿刺肺活检联合同步交叉法微波消融治疗高龄患者肺单发恶性倾向小结节的疗效。方法将48例肺单发恶性倾向小结节高龄患者随机分为2组,每组24例。试验组于穿刺活检后经异穿刺点交叉针道进行微波消融,对照组穿刺活检后经同轴套管同针道行微波消融,对比2组技术成功率、疗效、总有效率及并发症发生率。结果2组穿刺活检和微波消融操作成功率、总有效率及局部控制率均为100%。试验组中、重度气胸发生率为20.83%(5/24),对照组为58.33%(14/24);试验组中、大量胸腔积液发生率为8.33%(2/24),对照组为37.50%(9/24);试验组中、大量咯血发生率为12.50%(3/24),对照组为48.83%(11/24);组间差异均有统计学意义(P均<0.05)。随访6个月,2组患者均未出现并发症。结论CT定位下经皮穿刺肺活检联合同步交叉法微波消融治疗高龄患者肺单发恶性倾向小结节疗效确切,安全性较好。

Puncture biopsy combined with microwave ablation for single pulmonary nodule with malignant tendency in the elderly

Objective To observe the effect of CT-guided percutaneous lung biopsy crossed with simultaneously microwave ablation for treatment of pulmonary solitary nodule with malignant tendency in the elderly (>70 years). Methods A total of 48 aged >70 years solitary pulmonary nodule patients with malignant tendency were randomly divided into study group and control group (each n=24). Patients in study group underwent microwave ablation of the cross needle channel at different puncture points after biopsy, and those in control group underwent microwave ablation of the same needle channel after coaxial cannula puncture and biopsy. The technical success rate, curative effect, total effective rate and the complication rate were compared between groups. Results The success rate, total effective rate and local control rate of puncture biopsy and microwave ablation were both 100% in 2 groups. The incidence of media-severe pneumothorax in study group was 20.83% (5/24), in control group was 58.33% (14/24), of media-severe pleural effusion in study group was 8.33% (2/24), in control group was 37.50% (9/24), of media-severe hemoptysis in study group was 12.50% (3/24), in control group was 48.83% (11/24) (all P<0.05). During 6 months follow-up, no other complication occurred in both groups. Conclusion CT-guided percutaneous lung biopsy crossed with simultaneously microwave ablation was effective and safe in treatment of pulmonary solitary nodule with malignant tendency in the elderly.