| 张啸波,肖越勇,张肖,何晓锋,张欣,魏颖恬,李竞,张忠亮,马丽,杨杰,薛晓东.针道封堵技术预防CT引导下经皮穿刺肺结节射频消融同步活检出血[J].中国介入影像与治疗学,2021,18(1):13-17 |
| 针道封堵技术预防CT引导下经皮穿刺肺结节射频消融同步活检出血 |
| Needle tract occlusion technology for prevention of pulmonary hemorrhage during CT-guided percutaneous radiofrequency ablation and simultaneous biopsy of pulmonary nodules |
| 投稿时间：2020-11-07 修订日期：2020-12-18 |
| DOI：10.13929/j.issn.1672-8475.2021.01.004 |
| 中文关键词: 肺肿瘤 出血 明胶海绵,吸收性 活组织检查 蛇毒血凝酶 射频消融 |
| 英文关键词:lung neoplasms hemorrhage gelatin sponge, absorbable biopsy snake venom hemagglutinin radiofrequency ablation |
| 基金项目:国家自然科学基金面上项目（81771941）。 |
| 作者 | 单位 | E-mail | | 张啸波 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853
解放军医学院, 北京 100853 | | | 肖越勇 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | xiaoyueyong@vip.sina.com | | 张肖 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 何晓锋 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 张欣 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 魏颖恬 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 李竞 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853
中国人民武装警察部队特色医学中心医学影像科, 天津 300162 | | | 张忠亮 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 马丽 | 中国人民解放军总医院第一医学中心麻醉科, 北京 100853 | | | 杨杰 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 薛晓东 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | |
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| 中文摘要: |
| 目的 观察针道封堵技术预防CT引导下经皮穿刺肺结节射频消融（RFA）同步活检出血的效果。方法 回顾性分析66例接受CT引导下经皮穿刺RFA同步活检肺结节患者资料，对其中33例预防性使用明胶海绵-血凝酶封堵剂进行针道封堵（A组），33例未使用（B组），根据术后即刻CT图像判断并对比2组出血程度。结果 对66例均顺利完成手术，术中消融区晕征均完全覆盖病灶区域。术后即刻CT显示A组26例无或低级别出血、7例高级别出血，B组17例无或低级别出血、16例高级别出血（P=0.038）。A组21例、B组26例病灶≤ 2 cm，其中A组16例无或低级别出血、5例高级别出血，B组10例无或低级别出血、16例高级别出血（P=0.017）。结论 应用针道封堵技术可在一定程度上降低CT引导下经皮穿刺肺结节RFA同步活检的出血风险。 |
| 英文摘要: |
| Objective To explore the efficacy of needle tract occlusion technology (NTOT) for prevention of pulmonary hemorrhage during CT-guided percutaneous radiofrequency ablation (RFA) and simultaneous biopsy of pulmonary nodules. Methods Data of 66 patients with pulmonary nodules who underwent CT-guided percutaneous RFA and synchronous biopsy were retrospectively analyzed. Thirty-three patients who received prophylactically NTOT during operation were enrolled in group A (using), and the rest 33 were enrolled in group B. The degrees of pulmonary hemorrhage showed on immediate postoperative CT images were observed and compared between 2 groups. Results The treatment and sampling were successfully completed, and all the lesions were completely covered by the halo sign on CT images during ablation. CT images immediately after ablation showed 26 cases no or with low grade hemorrhage and 7 cases with high grade hemorrhage in group A, while 17 cases no or with low grade hemorrhage and 16 cases with high grade hemorrhage in group B (P=0.038). There were 21 cases in group A and 26 cases in group B with ≤ 2 cm lesions, among them 16 cases were found no or with low grade hemorrhage, 5 with high grade hemorrhage in group A, while 10 no or with low grade hemorrhage, 16 with high grade hemorrhage in group B (P=0.017). Conclusion NTOT could decrease the risk of hemorrhage during CT-guided percutaneous RFA and simultaneous biopsy of pulmonary nodules. |
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