低温等离子消融治疗部队官兵下鼻甲肥厚的远期疗效评价

目的：评价低温等离子消融治疗部队官兵肥厚性鼻炎的远期疗效。方法：采用低温等离子刀行下鼻甲打孔消融治疗179例部队官兵肥厚性鼻炎,术后半年以上观察远期效果。结果：采用VAS评分法,鼻塞患者一次消融后,评分在0—1分81例（93．10％）;二次消融评分在0～1分6例（6．90％）。所有患者未见明显并发症,无萎缩性鼻炎。结论：低温等离子消融下鼻甲治疗慢性肥厚性鼻炎疗效显著,具有操作简便、低温、微创、安全及并发症少等优点,而且远期疗效好,不需住院,不影响部队官兵的日常训练。     

低温等离子刀扁桃体减容联合腺样体消融术治疗儿童鼾症疗效观察

目的 评估低温等离子扁桃体减容联合腺样体消融术治疗儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效.方法 2008年1月~2013年5月我科诊治126例3~12岁OSAHS患儿,按照手术方式不同分为治疗组（59例）与对照组（67例）,治疗组采用低温等离子刀扁桃体减容术＋腺样体消融术,对照组采用低温等离子刀扁桃体切除术＋腺样体消融术,以术中出血量、术后疼痛评分及术后6个月疗效为评价指标,比较两组疗效.结果 治疗组术中出血量、术后疼痛评分均低于对照组（P＜0.05或P＜0.01）,两组术后6个月疗效比较无统计学差异.结论 低温等离子刀扁桃体减容联合腺样体消融术具有术中出血少、术后疼痛轻的优点,治疗儿童OSAHS可获得较好的疗效.     

鼻内镜下双极低温等离子刀治疗慢性肥厚性鼻炎123例

慢性肥厚性鼻炎是耳鼻咽喉常见病,传统治疗方法是鼻甲部分切除术。近几年激光、微波治疗的广泛应用,使得慢性肥厚性鼻炎的治疗取得了一定疗效,但因术长后鼻腔黏膜反应较重而影响疗效和手术开展。我科自2004年12月起采用双极低温等离子刀治疗慢性肥厚性鼻炎123例,经临床观察,疗效显著,患者满意,现报告如下。     

低温等离子刀治疗鼻腔术后肉芽增生粘连36例

低温等离子消融术在治疗鼻甲肥大、解除鼻阻塞、保护鼻甲黏膜功能等方面已取得较好疗效。2003年10月～2005年2月，我们采用低温等离子刀，治疗鼻内镜下鼻窦开放术后鼻腔囊泡、肉芽增生、息肉复发或粘连36例，疗效满意。     

下鼻甲骨折外移术加低温等离子消融治疗慢性肥厚性鼻炎的疗效观察

目的观察下鼻甲骨折外移加下鼻甲低温等离子消融治疗慢性肥厚性鼻炎的疗效及术后并发症。方法选择168例慢性肥厚性鼻炎患者,按入院先后顺序,随机分为观察组85例,对照组83例。观察组给予下鼻甲骨折外移加下鼻甲低温等离子消融,对照组给予下鼻甲骨折外移加下鼻甲部分切除。术前及术后6个月均用VAS评分标准评价患者鼻塞的主观感觉,并观察术后鼻甲黏膜修复情况及鼻腔干燥、出血、粘连情况。结果观察组患者术前鼻塞VAS评分为8.25±0.76,对照组为8.22±0.81,术后6个月观察组为2.45±0.88,对照组为2.69±0.97。两组术前和术后比较差异均有显著统计学意义（P〈0.01）,两组间疗效比较差异无统计学意义（P〉0.05）。观察组无明显并发症,对照组并发鼻腔干燥6例,鼻出血5例,两组间并发症比较差异有统计学意义（P〈0.01）。结论下鼻甲骨折外移加下鼻甲低温等离子消融具有疗效确切、安全、损伤小、并发症少等优点,具有重要的临床运用价值。     

低温等离子切除腺样体肥大24例临床分析

目的:探讨运用低温等离子刀手术系统切除小儿肥大型腺样体的临床疗效.方法:经用纤维鼻咽喉镜检查证实24例年龄在5～13岁的腺样体肥大患者.伴有不同程度睡眠打鼾、鼻塞、流脓涕、听力下降等症状.采用美国杰西低温等离子刀手术系统切除.结果:术后随访≥1年,24例睡眠鼾声、鼻塞、流脓涕治愈,听有有所提高.统计腺样体残留1例占4.16%,术中出血平均20ml左右,平均住院天数(5±2)d.结论:低温等离子切除腺样体手术安全可靠、切除彻底、很少残留、并发症少、术后恢复快.     

低温等离子射频对舌组织的影响

目的 研究低温等离子射频技术对组织的影响及恢复情况。方法 选择小猪18只,用离子刀以不同的能量在猪舌上打孔治疗,干不同时期处死,观察舌组织的形态变化及恢复情况。结果 低温等离子射频对组织的影响类似于烧烫伤的反应-组织3周左右即修复。结论 低温等离子射频具有安全、操作简单、损伤小、恢复快等优点。     

低温等离子微创治疗早期喉癌

目的探讨5例早期喉癌的低温等离子微创治疗方法及疗效。方法 5例中声门上型1例,声门下型1例,声门型3例。均在全麻支撑喉镜下使用低温等离子切除病灶,其中声门上型1例术前先行气管切开和留置胃管,其余4例患者均在全麻下经口腔插管,经口切除肿瘤,所有患者术后行放疗。结果患者术后恢复快,痛苦少,生活质量高,费用低,随访1年无一例复发。结论对于不同类型的早期喉癌采用低温等离子治疗安全有效。     

应用低温等离子刀治疗慢性肥厚性鼻炎疗效观察

对慢性鼻炎中肥厚性鼻炎的双下鼻肥大而引起鼻腔堵塞、头痛等症状,在低温等离子激光出现之前,治疗主要以药物保守治疗,双侧下鼻甲部分切除术治疗,微波治疗三种形式为主,2006年起我们应用美国安泰低温消除等离子刀系统治疗慢性肥厚性鼻炎48例,效果较好,并与微波治疗方法进行比较,现总结报道如下。     

低温等离子射频消融术与射频靶点热凝术治疗颈椎间盘突出症的临床疗效观察

目的 探讨低温等离子射频消融术与射频靶点热凝术治疗颈椎间盘突出症临床疗效的对比.方法 回顾性分析因颈椎间盘突出症住院80例患者的临床疗效,其中行低温等离子射频消融术38例,行射频靶点热凝术42例.比较2组术后3 d VAS评分、术后1月及术后6月的JOA评分.结果从患者术后3 d VAS评分,术后1月、6月JOA评分比较来看,低温等离子射频消融术与射频靶点热凝术对颈椎间盘突出症具有显著疗效.低温等离子射频消融术在术后3 d、1月的疗效优于射频靶点热凝术(P<0.05),而术后6月再次对患者进行随访发现,低温等离子射频消融术与射频靶点热凝术疗效无显著差别.结论 从短期评分结果来看,在治疗颈椎间盘突出症时低温等离子射频消融术后患者较射频靶点热凝术后患者反应轻,症状缓解快.从长期随访结果来看,低温等离子射频消融术与射频靶点热凝术疗效无统计学差异.     

低温等离子髓核减压术对神经根型颈椎病的疗效及其与弧弦距的相关性

 目的 探讨低温等离子髓核减压术治疗神经根型颈椎病患者的疗效及其与弧弦距的相关性。方法 选择2018-11至2019-07在北京中医药大学东直门医院骨科诊断为神经根型颈椎病的住院患者34例,测量其弧弦距数值,采用经皮穿刺低温等离子髓核减压术治疗,评定治疗效果采用疼痛视觉模拟(VAS)评分、颈椎功能障碍指数(NDI)评分的方法量化,于术前1 d、术后1周、术后1个月由患者填写自身情况。结果 (1)在术前1 d、术后1周、术后1个月VAS评分分别为(7.21±0.687)分、(3.12±1.225)分、(1.94±1.278)分。NDI评分分别为(15.79±2.185)分、(7.85±2.476)分、(6.12±3.003)分,术后1周VAS评分、NDI评分均较治疗前降低,差异有统计学意义(P<0.01),术后1个月VAS评分、NDI评分较术后1周降低,差异有统计学意义(P<0.01)。弧弦距数值与术前1 d VAS评分及NDI评分均没有明确的相关性(r=0.238;r=0.250),弧弦距数值与术后1个月和术前1 d VAS评分差值呈正相关且差异有统计学意义(r=0.55,P<0.05),弧弦距数值与术后1个月和术前1 d NDI评分差值呈正相关且差异有统计学意义(r=0.384,P<0.05)。结论 应用低温等离子髓核减压术治疗神经根型颈椎病,从疼痛及日常生活功能方面进行观察近期效果良好,疗效较稳定,是一种安全有效的治疗神经根型颈椎病的介入手术方法。     

超声引导下射频消融治疗子宫肌瘤疗效分析

目的：采用超声引导下射频消融治疗子宫肌瘤。探讨微创技术治疗子宫肌瘤的临床效果。方法：对自愿接受射频消融自凝刀治疗的60例子宫肌瘤患者，其中粘膜下肌瘤9例，壁间肌瘤51例，在超声引导下将自凝刀经阴道置入肌瘤进行射频消融治疗。结果：治疗后随访3、6个月，瘤体缩小率100％。9例粘膜下肌瘤患者术后月经恢复正常；26例擘间肌瘤经节增多者中．术后3、6个月经节恢复正常者达83．3％、95．4％。结论：射频消融自凝刀治疗子宫肌瘤是一种微创并保留子宫的好方法，方法简单、安全、易推广。     

Percutaneous radio-frequency ablation of osteoid osteoma: technique and preliminary results]

PURPOSE: To report our personal experience with the percutaneous technique for in situ destruction of osteoid osteoma using radio-frequency ablation. MATERIAL AND METHODS: From January 2000 to January 2001 we performed 16 radio-frequency ablations in 15 patients. All candidates for treatment had previously undergone clinical and radiologic examinations to confirm features typical of osteoid osteoma. After administration of spinal anesthetic, procedures were performed with CT-guidance, using a Kirschner wire introduced into the localized lesion, and a guiding cannula. A hole was first cut into the bone with a cutter, then a few biopsy specimens were obtained with a Jamshidi needle. Finally, we introduced a small radio-frequency electrode into the bone, through the biopsy track. Sufficient current was used to heat the electrode tip to 85-90 degrees C with consequent thermal necrosis of the tissue. The healing was continued for 6 minutes. RESULTS: All patients well tolerated the percutaneous procedure and only 1 underwent a second, successful radio-frequency ablation. In all cases, pain relief was noted to occur very rapidly and all patients could bear full weight on the treated extremity within 24 hours after the procedure. No late complications attributable to the ablation were noted, except for a small eschar next to the puncture site. DISCUSSION AND CONCLUSIONS: The results of the present study suggest that percutaneous ablation is preferred to operative excision because it generally requires shorter hospital stay and is not associated with complications. Furthermore, in our experience, pain relief was noted to occur very rapidly in 100% of cases. In agreement with the literature data, our results show that CT-guided percutaneous radio-frequency ablation can actually replace operative excision in the treatment of osteoid osteoma as it achieves the same clinical outcomes with significantly lower costs.     

Tumor ablation with radio-frequency energy

Tumor ablation by using radio-frequency energy has begun to receive increased attention as an effective minimally invasive approach for the treatment of patients with a variety of primary and secondary malignant neoplasms. To date, these techniques have been used to treat tumors located in the brain, musculoskeletal system, thyroid and parathyroid glands, pancreas, kidney, lung, and breast; however, liver tumor ablation has received the greatest attention and has been the subject of a large number of published reports. In this article, the authors review the technical developments and early laboratory results obtained with radio-frequency ablation techniques, describe some of the early clinical applications of these techniques, and conclude with a discussion of challenges and opportunities for the future.     

Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases.

Chondroblastomas are benign cartilaginous lesions; however, intervention is necessary to stop progression and alleviate pain. The authors evaluated three patients in whom minimally invasive percutaneous radio-frequency heat ablation was used to treat pathologically proven chondroblastoma to determine whether this treatment demonstrated long-term success. The authors found that this approach may be an effective alternative to surgical intervention in some cases.     

射频消融治疗椎旁软组织转移性肿瘤的初步应用

目的 探讨经皮射频消融(RFA)治疗椎旁软组织转移瘤方法及可行性.方法 应用1500X型多极温控射频发生器,对3例椎旁转移瘤患者予以RFA治疗.在DSA引导下,穿刺入椎旁转移瘤内,插入射频电极针,射频功率设定为30～80 W.消融温度设定为60～90℃,消融治疗时间8～15 min.结果 3例患者术前疼痛症状均有不同程度缓解,无感染、针道转移等并发症.结论 经皮RFA具有安全、微创、操作简便的特点,为治疗椎旁软组织转移性肿瘤提供了一种新的治疗手段,其远期效果需进一步观察.     

肝动脉化疗栓塞联合射频消融治疗中晚期肝癌的临床疗效分析

目的：评价联合应用肝动脉化疗栓塞和经皮射频消融治疗中晚期肝癌的临床应用价值。方法：经病理、AFP或影像学证实的符合标准的中晚期肝癌112例,按治疗方法随机分为单纯肝动脉化疗栓塞组（TACE）和TACE＋射频消融组（RFA）。TACE组54例,TACE＋RFA组58例。结果：TACE组治疗有效率为44%,联合治疗的有效率为68%,两组间差异有统计学意义（P〈0.01）;TACE组患者1年、2年和3年生存率分别为85%、64%和23%,中位生存期1.725年,联合介入治疗组患者1年、2年和3年生存率分别为93%、88%和79%,中位生存期为2.296年。联合介入治疗组的生存率及生存期显著高于TACE组（P〈0.05）。结论：联合应用肝动脉化疗栓塞和经皮射频消融治疗可显著提高中晚期肝癌患者的生存率,延长生存期。     

经支撑喉镜下低温等离子刀消融术治疗早期喉癌的疗效

 目的 探讨经支撑喉镜下低温等离子消融术治疗早期喉癌的疗效。方法 选取2012-01至2018-06在医院接受低温等离子消融术联合支撑喉镜治疗的32例T1、T2期喉癌患者的临床资料,手术前、后均未进行放化疗,所有病例术后进行严密跟踪随访,统计患者的术后恢复、并发症及复发情况。结果 所有患者随访半年以上,手术创面光滑,无感染发生,患者均对声音恢复度满意,均无带瘤生存;累及前联合病变2例,术后前联合粘连程度较轻,对日后发音及日常交流无影响;术后1～2个月3例经电子喉镜复查见术区肉芽组织生长,4个月后瘢痕化;所有患者均无复发情况。结论 低温等离子手术联合支撑喉镜能够发挥可塑性等离子刀头的技术优势,在保全喉功能的基础上得到局部肿瘤较好的控制效果。     

内镜下射频治疗消化道息肉500例临床疗效分析

目的观察射频治疗消化道息肉的效果。方法用射频治疗仪，内镜下对500例610颗不同大小，有蒂或无蒂，单发或多发息肉，予以射频电切治疗。结果全部病例均治愈，无穿孔及电凝电切术后综合症。结论射频电治疗消化道息肉效果肯定，不开刀、无痛苦、费用低、前景广阔。     

High or low dose radioiodine ablation of thyroid remnants?

The need for high dose radioiodine for ablation of remnants in patients with thyroid cancer is still in question. We compared the effectiveness of high and low dose 131I for ablation in patients in a prospective randomized study after surgical thyroidectomy. Twenty patients with differentiated pT2-3NoMo thyroid cancer were studied. The uptake was 5%-10% at 24 h. Ten patients received 100 mCi, the others 30 mCi 131I. Three months later all patients received a therapeutic dose of 150 mCi 131I. Another twenty patients with known distant metastases (pulmonary and/or bone) of differentiated thyroid cancer were studied. The remnant uptake was between 4%-10%. Ten patients received 300 mCi and ten 30 mCi 131I as ablation dose. Three months later all received 300 mCi 131I. The uptake at day seven was calculated for the same metastases from a whole body scan after both treatments. If effective ablation was defined as 24 h uptake in the remnant of less than 1%, then the ablation was effective in eight out of ten of the high dose and in seven out of ten of the low dose group. In pT2-3, N X M1 patients the ablation was effective in seven out of ten cases in both groups. If "effective" ablation was defined as an uptake of less than 0.5%, then the ablation was effective both in NoMo and in N X M1 patients in five out of ten with low dose and in six out of ten with high dose ablation treatment.(ABSTRACT TRUNCATED AT 250 WORDS)