CT引导下125I粒子植入腰淋巴结转移瘤穿刺路径初探

目的 探讨CT引导下125I粒子植入腰淋巴结转移瘤的穿刺路径,为临床提供安全可靠技术指导.方法 CT引导下125I粒子植入腰淋巴结转移瘤,据转移瘤的不同位置:左腰、右腰、中间腰淋巴结病变部位采用相应穿刺植入方法,同时考虑规避危及器官,设计不同的进针路径.结果 左腰、右腰、中间腰淋巴结125I粒子植入常用穿刺方法分别为后入路即经皮经胸腰髂肋肌法、侧入路即经肝经十二指肠法或者是后入路经皮经胸腰髂肋肌法、前入路即经肠系膜同时采用同轴针法.结论 CT引导下125I粒子治疗腰淋巴结转移瘤采用不同穿刺路径是可行的,增加了操作的安全性.

CT-guided 125I seed implantation for the treatment of lumbar lymph node metastases: a preliminary discussion on the puncturing approaches

Objective To discuss the commonly used puncturing approaches in CT-guided 125I seed implantation for lumbar lymph node metastases in order to provide safe and reliable technical guidance for clinical practice.Methods Under CT guidance,125I seed implantation for lumbar lymph node metastases was performed.According to different locations of metastatic lymphadenopathy (left waist,right waist or middle waist),the corresponding puncture route and implantation method were adopted.Meanwhile,different puncturing approach was designed in order to avoid damage to vital organs.Results For the performance of 125I seed implantation for the lymphadenopathy located at the left waist,right waist and middle waist,the commonly used puncturing approaches were percutaneous transthoracic lumboiliac costal muscle method (i.e.back approach),trans-hepatic trans-duodenal method (i.e.lateral approach) or back approach method,and trans-mesenteric approach together with coaxial needle method (i.e.anterior approach) respectively.Conclusion It is clinically feasible to use different puncturing approaches in performing 125I seed implantation for lumbar lymph node metastases,the suitable puncturing approach can ensure a successful and safe operation.