比较水隔离与温度监测技术在超声引导经皮微波消融肾癌中的效果

郝国良; 于杰; 程志刚; 张旭; 曹丰; 于晓玲; 韩治宇; 刘方义; 钱同刚; 穆梦娟; 李鑫; 梁萍

doi:10.3969/j.issn.2095-5227.2018.05.002

比较水隔离与温度监测技术在超声引导经皮微波消融肾癌中的效果

Hydrodissection technology versus thermal monitoring technology in ultrasound-guided percutaneous microwave ablation for renal cell carcinoma

摘要

摘要: 目的评估水隔离技术和温度监测技术应用于危险部位T1a期肾癌行超声引导下经皮微波消融的疗效。方法回顾性分析2006年4月-2017年12月我科收治的61例肿瘤位于危险部位的T1a期肾癌患者（61个病灶，平均直径2.8±0.7 cm），采用超声引导下经皮微波消融治疗，根据使用辅助技术的方式分为水隔离技术组和温度监测组，比较两组患者肿瘤局部进展率和生存情况。结果水隔离组32例，温度监测组29例，两组年龄、性别、肿瘤最大径、肿瘤位置、消融时间及功率无统计学差异（P均> 0.05）；技术有效率（微波消融后1个月增强影像显示完全消融）达到100%（61/61）。水隔离组的肿瘤局部进展率为0（0/32），温度监测组为13.8%（4/29），差异有统计学意义（P=0.042）；至随访结束，水隔离组与温度监测组均无肿瘤相关性死亡。结论该研究结果表明，超声引导下经皮微波消融危险部位的T1a期肾癌中水隔离技术的疗效要优于温度监测技术。

Abstract: Objective To evaluate hydrodissection technology versus thermal monitoring technology in ultrasound (US)-guided percutaneous microwave ablation (MWA) for T1a stage renal carcinoma located in dangerous location. Methods Totally 61 cases(mean diameter 2.8±0.7 cm) at T1a stage renal cell carcinoma (RCC) located in dangerous location were treated in our department from April 2006 to December 2017. According to the use of assistive technology, patients were divided into hydrodissectiom technology group and temperature monitoring group to compare the local tumor progression (LTP) rate and survival condition. Results There were 32 cases in the hydrodissection group and 29 cases in the thermal monitoring group. No significant difference in age, gender, maximum diameter, location, time of ablation and the power of ablation was found between the two groups (all P> 0.05). The technical efficiency after microwave ablation was 100% (61/61) in all patients. The LTP rate in hydrodissection group was significantly lower than that in thermal monitoring group (0 vs13.8%, P=0.042). No cancer-related death occurred in two groups. Conclusion The study results show that the effect of hydrodissection technology is superior to thermal monitoring technology in US guided percutaneous MWA for T1a RCC located in dangerous location.

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