射频消融术治疗肺部恶性肿瘤的临床观察

目的观察射频消融术（RFA）治疗肺部恶性肿瘤的临床疗效和安全性。方法对25例肺部肿瘤患者的31个肿瘤行局麻下CT引导经皮射频消融术，术后通过影像学、生存质量、并发症、疾病进展时间等方面评价RFA的治疗价值。结果31个肿瘤均顺利完成了射频消融热毁损肿瘤，其中3个肿瘤进行了2次重叠消融，3例患者失访。31个肿瘤经治疗后病灶完全毁损率达71.43％。完全毁损病灶治疗后6个月内未见复发；而部分毁损病灶治疗后1个月复发率为87.50％，3个月后复发率达到了100％，需行二次射频治疗。胸痛、发热、咳嗽咳痰是患者术后的主要并发症，且均在可耐受范围。患者治疗后各项生存质量评分均有明显变化（t分别=11.43、-4.06、-8.72、-10.89、-3.72、-8.97，P均＜0.05）。病灶完全毁损和病灶部分毁损患者的无进展生存期比较，差异有统计学意义（t=2.10，P＜0.05）。所有患者的1年生存率为60.00％，2年生存率为40.00％。结论射频消融治疗肺部恶性肿瘤近期疗效确切、安全，不良反应能耐受，可明显提高肺癌患者的生存质量。

Clinical observation of radiofrequency ablation for treating patients with lung cancer

Objective To observe the clinical efficacy and safety of radiofrequency ablation （RFA） for treating patients with lung cancer. Methods Thirty-one lesions in 25 patients with lung tumor which were non-small cell lung cancer （NSCLC） and metastatic lung tumor were underwent percutaneous adiofrequency ablation.It can evaluate the therapeutic value of the RFA postoperative through the images, quality of life, complications and disease progression time. Results All lesions were taken RFA successfully. Three lesions were taken overlapping ablations for two times and three patients were lost follow-up.The total complete ablation rate was 71.43%in 31 lesions. Completely ablation lesions did not recurred at 6 months after treatment and portion ablation lesions recurrence rate was 87.5% at 1 month after treatment while 100%at 3 months after treatment. The Chest pain, fever, cough were the major complications which were all in tolerance. The scoring of quality of survival in patients with lung cancer after treatment were significantly improved （t=11.43, -4.06, -8.72, -10.89, -3.72, -8.97, P〈0.05）. The progression-free-survival of completely ablation lesions was significantly higher than portion ablation lesions （t=2.10,P〈0.05）. One year survival rate was 60.00% and 2 years survival rate was 40.00%. Conclusion Using RFA to treat NSCLC and metastatic lung tumors is efficacious and safe.The adverse reactions were tolerated. It can obviously improve the quality of survival of patients with lung cancer.