碘难治性分化型甲状腺癌经索拉非尼治疗致亚急性肝衰竭一例

笔者报道了1例碘难治性分化型甲状腺癌（RAIR-DTC）经索拉非尼治疗致亚急性肝衰竭的病例,并从临床症状、实验室检查、影像学检查、组织病理学检查结果以及患者的临床处置与转归等方面综合分析了该病的特点。笔者通过文献复习加深了对RAIR-DTC以及索拉非尼治疗晚期甲状腺癌的疗效和相关不良反应的认识,旨在提示临床医师在遇到相...     

分化型甲状腺癌骨转移大剂量131I治疗后出现重度骨髓抑制一例

笔者报道了一例131I治疗分化型甲状腺癌（DTC）骨转移出现重度骨髓抑制的病例,从临床诊断、骨髓造血系统变化、治疗过程是否规范等方面分析该病例特点,并通过文献复习加深了对131I诊治DTC骨转移的疗效以及骨髓造血影响的认识:131I诊治DTC骨转移的临床效果明显,但随着累积剂量的提升以及患者对131I治疗个体敏感度的不同可能会发生骨髓造血系统的白细胞或血小板一过性下降。对于广泛骨转移患者131I治疗时要高度警惕骨髓抑制的发生,要尽可能考虑累积治疗剂量的因素;尽量延长再次治疗的间隔时间;出现骨髓抑制现象时,要择期使用131I治疗。     

肿瘤低剂量CT灌注成像的技术进展

肿瘤的血管生成是其重要特征之一,是肿瘤发生、发展的重要基础,而CT灌注成像(CTPI)作为一种功能成像方法可反映肿瘤内部的血流动力学改变,在临床中常用于鉴别肿瘤性质、肿瘤分期,预测病人疗效、治疗效果等。但CTPI较大的辐射剂量以及在可重复性上存在争议使其发展受到限制。低剂量CTPI能够更好地适应实际临床工作。就低剂量CTPI的原理、技术特点及其在肿瘤成像中的应用前景等予以综述。     

肺癌治疗影像评价的研究进展

近年来,随着肿瘤生物学的发展,许多新的肺癌治疗手段已被临床采用,而对于这些治疗方法的疗效的准确评估是肿瘤治疗过程中重要的环节之一;影像学检查作为当前肺癌诊断过程中最重要、最方便、最首选的诊断措施,其已成为临床评估肺癌治疗疗效的重要方法之一,而随着影像学技术的发展,更多新的无创的、可重复的影像学检测技术已被应用在临床中,这些技术对于肺癌的早期诊断、疗效判断、预后判断等方面均至关重要;本文将从传统肺癌治疗评价标准、影像学技术在肺癌疗效评估中的发展以及新的评价标准三方面阐明当前对于影像学评估肺癌疗效的研究进展。     

射频消融治疗肾癌现状

近年来射频消融日益广泛应用于肾癌治疗,随着操作技术的不断发展,已在临床上取得显著的近期疗效,具有微创、安全、操作方便、并发症轻、患者痛苦少等特点。其未来发展的关键在于改进电极针,提高射频技术,联合c其他疗法等以提高疗效,并建立更合理的包括影像检查技术在内的疗效评价标准。     

肺癌射频消融治疗

近年来射频消融广泛应用肺癌治疗上,目前尚未建立严格的适应症及禁忌症标准,随着操作技术的不断发展,已在临床上取得显著的近期疗效,具有操作方便,并发症轻,患者痛苦少等特点,未来发展的关键在于改进电极针,提高射频技术,联合其它疗效等以提高疗效,并建立更合理的包括影像检查技术在内的疗效评价标准。     

内窥镜下行后路腰椎管减压椎间融合与经皮椎弓根螺钉固定术护理

目的：探讨椎管减压联合椎弓根螺钉内固定术手术护理及在保障腰椎管狭窄、退变性腰椎不稳、椎体滑脱治疗效果中的重要作用。结果：我院自2003至今成功利用内窥镜下B-Twin（可膨胀脊柱融合器系统）椎间融合术治疗退变性腰椎不稳37例、经皮椎弓根螺钉固定治疗轻度腰椎滑脱5例,术中无神经根、脊髓及大血管损伤等严重并发症,从临床疗效以及术中、术后并发症等方面进行评价。术后随访6～18个月,平均1年,疗效满意,手术护理为提高疗效起到了重要作用。     

膀胱嗜铬细胞瘤的诊治

嗜铬细胞瘤主要来源于肾上腺素能系统嗜铬细胞,在异位嗜铬细胞瘤中,膀胱嗜铬细胞瘤较少见。本文就膀胱嗜铬细胞瘤其发病原因、临床病理特点、诊断、治疗以及预后等概况进行综述。     

国产双伞形封堵器治疗多发性巨大肺动静脉瘘

多发性肺动静脉瘘一直是临床治疗的难题,介入放射技术应用于该疾病的治疗以来,取得了较为满意的临床疗效,但使用的栓塞材料种类较多,栓塞性能各不相同,有些材料在应用过程中还发现很多问题,甚至出现异位栓塞等严重并发症,这些问题往往和栓塞材料的设计缺陷以及对疾病的病理特点认识不足有关。     

后路小切口微创椎弓根螺钉治疗55例脊柱胸腰段骨折的临床疗效观察

目的：探讨后路小切口微创椎弓根螺钉治疗脊柱胸腰段骨折的临床疗效,为临床医师选择术式提供参考。方法选择2013年10月～2015年12月收治的110例脊柱胸腰段骨折患者作为研究对象,把全部患者依据治疗方法的不同分成对照组与治疗组,每组分别有患者55例。对照组患者实施传统切口手术治疗,治疗组患者实施后路小切口微创椎弓根螺钉治疗,对两组患者的临床疗效进行对比。结果治疗组患者的平均手术时长、术中出血量以及术后卧床时间均要明显少于对照组（ P＜0.05）;治疗组患者手术后的VAS评分以及Cobb角要明显小于对照组和手术前（ P＜0.05）;治疗组并发症发生率是3.64％,对照组并发症发生率是21.82％,治疗组并发症发生率要明显小于对照组（ P＜0.05）。结论脊柱胸腰段骨折患者应用后路小切口微创椎弓根螺钉治疗具有非常理想的临床疗效,具有创伤小、术中出血量少以及术后恢复快等特点,能够明显减少患者疼痛以及并发症发生率,值得在临床上大力推广应用。     

射频消融技术临床应用与发展趋势

近20年来,射频消融(RFA)技术应用于肿瘤治疗有了巨大的发展.从治疗肝癌开始,逐渐发展到治疗肺癌、骨癌、肾癌、乳腺癌、前列腺癌等实体肿瘤.2008年的统计报告表明:RFA治疗肿瘤的方法,在同类治疗方法中占据了9%市场份额.并且,在未来的数年内,RFA治疗肿瘤这一方法发展,将以年均13%的速度增长.     

肿瘤射频消融:电极的类型和消融灶的特点

在早期,由于受射频电极周围被消融组织炭化和气化的影响,射频消融(RFA)范围小于1.8 cm,难以满足临床对实体性肿瘤RFA治疗的要求.随着RFA设备和电极的不断改进,消融范围不断扩大,更好地满足了临床上对肿瘤RFA治疗的需要,为不能或不愿外科手术的恶性肿瘤患者提供了新的治疗手段.本文就射频电极的类型及消融灶的特点做一...     

Early experience with percutaneous radiofrequency ablation of small solid renal masses

OBJECTIVE: Incidental small renal-cell masses are often seen in elderly patients with significant comorbidity who are unfit to undergo major surgery. This study was conducted to determine the safety and efficacy of percutaneous imaging-guided radiofrequency ablation in the management of small solid renal masses, almost all of which are renal cell cancers. CONCLUSION: Early experience suggests that radiofrequency ablation is a safe, well-tolerated, and minimally invasive therapy for patients with solid renal masses. In the era of nephron-sparing surgery, radiofrequency ablation may have a role in the management of small problematic renal masses.     

Ablación por radiofrecuencia en la enfermedad tiroidea y paratiroidea

Radiofrequency ablation is a well-known, safe, and effective method for treating benign thyroid nodules and recurring thyroid cancer as well as parathyroid adenomas that has yielded promising results in recent years. Since the Korean Society of Thyroid Radiology introduced the devices and the basic techniques for radiofrequency ablation in 2012, radiofrequency ablation has been approved all over the world and both the devices and techniques have improved.This review aims to instruct interventional radiologists who are doing or intend to start doing radiofrequency ablation of thyroid and parathyroid lesions, as well as thyroid and parathyroid specialists who provide pre- and post-operative care, in the training, execution, and quality control for radiofrequency ablation of thyroid nodules and parathyroid adenomas to optimize the efficacy and safety of the treatment.     

超选择性肾动脉栓塞术联合射频消融治疗肾癌的临床应用

目的 探讨超选择性肾动脉栓塞术联合射频消融(RFA)治疗肾癌的疗效.方法 分析2009年1月至2011年4月9例肾癌患者超选择性肾动脉栓塞联合RFA.患者均在超选择性肾动脉栓塞术后3～7 d,在CT引导下行RFA.术后1个月行肾脏病灶穿刺活检和CT增强检查评价其疗效.结果 9例患者随访1～6个月,未发现.肾脏肿瘤增大,...     

Radiofrequency ablation of pulmonary tumors

The development of image-guided percutaneous techniques for local tumor ablation has been one of the major advances in the treatment of solid tumors. Among these methods, radiofrequency (RF) ablation is currently established as the primary ablative modality at most institutions. RF ablation is accepted as the best therapeutic choice for patients with early-stage hepatocellular carcinoma when liver transplantation or surgical resection are not suitable options and is considered as a viable alternate to surgery for inoperable patients with limited hepatic metastatic disease, especially from colorectal cancer. Recently, RF ablation has been demonstrated to be a safe and valuable treatment option for patients with unresectable or medically inoperable lung malignancies. Resection should remain the standard therapy for non-small cell lung cancer (NSCLC) but RF ablation may be better than conventional external-beam radiation for the treatment of the high-risk individual with NSCLC. Initial favourable outcomes encourage combining radiotherapy and RF ablation, especially for treating larger tumors. In the setting of colorectal cancer lung metastases, survival rates provided by RF ablation in selected patients, are substantially higher than those obtained with any chemotherapy regimens and provide indirect evidence that RF ablation therapy improves survival in patients with limited lung metastatic disease.     

Renal cell carcinoma radiofrequency ablation: evaluation of efficacy based on histological correlation

Percutaneous image-guided ablation with the use of radiofrequency has recently received much attention as a minimally invasive technique for the treatment of solid malignancies. Renal cell carcinomas (RCCs) were among the first extrahepatic tumours to be targeted with radiofrequency ablation (RFA). The aim of this study is to present the efficacy of RFA in RCC and the factors that have an impact on the attained necrosis with regards to the histological findings.     

经导管射频消融治疗心房颤动的回顾性分析

目的探讨经导管消融治疗心房颤动的有效性和安全性。方法对我科自1999年开始行导管消融治疗的80例房颤病例资料进行回顾性分析,比较肺静脉节段性消融术(SPVA)20例和肺静脉环形消融术(CPVA)60例两组的操作相关指标安全性及临床效果。结果显示80例病例中两组的基线资料和平均操作时间差异无统计学意义。但SPVA组的平均X线透视时间长(P<0.05),平均操作时间相似(P>0.05)。术后随访6～12月时,总成功率73.3%,消融过程中出现严重并发症(急性心包填塞)1例,经抢救存活。结论在条件成熟的导管室,经导管消融阵发性房颤是可行的,对大部分患者有效。     

射频消融治疗眼周汗管瘤的疗效观察

目的评估射频消融治疗眼周汗管瘤的临床疗效。方法 64例眼周汗管瘤患者接受刺入式射频消融治疗,手术在头式放大镜下进行,针状消融电极与射频发射器相连,刺入皮损并将射频能量传输至位于真皮层的病灶底部。治疗前后分别对患处拍照,以数码照片评分及患者满意度调查结果为观察指标。结果每例患者最多进行3次治疗,每次术后评估临床疗效,评分≥3级的患者比率依次为71.9%,83.3%和100%。医师评估与患者评价结果的一致性(第1次治疗后kappa=0.78;第2次治疗后kappa=0.82)。结论刺入式射频消融可以有效、精准、安全地治疗眼周汗管瘤。     

Radiofrequency ablation of bony metastatic disease

Image-guided radiofrequency (RF) ablation is an emerging alternative therapy for treatment of cancer in patients who can not undergo surgical resection. We have performed RF ablation on patients to locally treat and palliate painful osseous metastatic disease for several years. We present an overview of various applications of RF ablation for treating osseous metastatic disease.