CT引导下经皮复合式冷冻消融治疗肺恶性肿瘤的有效性及安全性

目的 观察CT引导下经皮复合式冷冻消融治疗肺恶性肿瘤的有效性和安全性。方法 回顾性分析22例接受CT引导下经皮冷热交替复合式冷冻消融治疗肺恶性肿瘤患者，根据病灶大小、形态及部位分为根治性消融（15例）及姑息性消融（7例），观察术中及术后4周内不良反应及并发症；于术后1、3、6个月复查胸部增强CT，以改良实体瘤疗效评价标准（mRECIST）评价疗效。结果 22例均顺利完成消融，术中无明显不良反应。6例术中及术后即刻出现少量气胸或液气胸，未经干预自行改善；2例术中局部皮肤轻度冻伤，予局部处理后缓解；1例术后1周出现大量气胸，给予胸腔闭式引流后恢复；无其他并发症。15例根治性消融术后1、3、6个月完全缓解分别为14例（14/15，93.33%）、14例（14/15，93.33%）及13例（13/15，86.67%）；7例姑息性消融术后1、3、6个月局部缓解分别为7例（7/7，100%）、6例（6/7，85.71%）及4例（4/7，57.14%）。结论 CT引导下冷热交替复合式冷冻消融治疗肺恶性肿瘤短期效果确切、安全可控。

Efficacy and safety of CT-guided percutaneous compound cryoablation for malignant lung tumors

Objective To observe the efficacy and safety of CT-guided percutaneous compound cryoablation for malignant lung tumors. Methods Data of 22 patients with malignant lung tumors who received CT-guided percutaneous compound cryoablation with alternating heat and cold were retrospectively analyzed. According to the size, morphology and location of the lesions, radical ablations were performed in 15 cases, while palliative ablations were performed in 7 cases. Adverse reactions and complications during operation and within 4 weeks after operation were observed. Enhanced thoracic CT was reviewed 1, 3 and 6 months after treatments, and the local ablation efficacy was evaluated using modified-response evaluation criteria in solid tumors (mRECIST). Results All ablation were successfully accomplished in 22 patients without obvious intraoperative adverse effects. Slight pneumothorax or hydropneumothorax occurred in 6 cases during and immediately after operation, and then recovered without intervention. Local skin frostbite was noticed in 2 cases during operation, which recovered after local treatment. One case suffered from delayed massive pneumothorax 1 week after operation and relieved through thoracic drainage. No other complications occurred. One, 3 and 6 months after operation, among 15 patients who underwent radical ablation, complete response was observed in 14 (14/15, 93.33%), 14 (14/15, 93.33%) and 13 (13/15, 86.67%) cases, respectively, while among 7 cases who underwent palliative ablation, partial response was found in 7 (7/7, 100%), 6 (6/7, 85.71%) and 4 (4/7, 57.14%) cases, respectively. Conclusion CT-guided compound cryoablation with alternating heat and cold for malignant lung tumors had definite short-term local effect and controllable safety.