氩氦冷冻治疗肺癌对心脏及大血管的影响

目的 观察氩氦冷冻治疗肺癌过程中对大血管的影响。方法 暴露兔颈动脉，直接用氩氦刀冷冻，观察血管的变化。在69例肺癌患者中，行CT引导下经皮穿刺氩氦刀直接冷冻包绕于大血管的肿瘤。结果 经氩氦刀冷冻后，兔颈动脉外观无异常，血流正常。在肺癌患者中也可见经氩氦刀冷冻后，侵犯上腔静脉、主动脉等大血管或心脏的肿瘤内有冰球形成，但无严重副作用发生。结论 氩氦刀治疗对大血管无明显影响。对侵犯心脏和大血管的肺癌，CT引导下氩氦刀治疗是一种可选择的治疗方法之一。

The influence of cryosurgery on great vessels and heart in patients with lung cancer

Objective To evaluate the effects of cryosurgery on the great vessels and heart in patients with lung cancer. Methods At first, the changes of rabbit cervical artery were observed during and after cryosurgery. Then, CT-guided percutaneous lung cryotherapy (PLC) was performed in 69 patients with 73 pulmonary masses encroaching on the great vessels and heart using 2 or 3 mm cryoprobes. Results In animal model, rabbit cervical artery looked well and blood flow was normal after ice thawing. In patients with lung cancer, CT-visualized immediate ice formation appeared beyond tumor margins within 10 minutes after cryotherapy. No major bleeding or other severe sequelae was observed. Conclusion CT-guided PLC is a promising treatment for pulmonary neoplasms invading or abutting the great vessels or heart, as well as showing minimal procedural complications or treatment sequelae.