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目的探讨CT引导下经皮全面冷冻治疗Ⅳ期肺癌的术后不良反应及疗效。方法对2004年8月至2011年11月广州复大医院收治的54例Ⅳ期肺癌患者进行回顾性分析,患者分为全面冷冻组31例(同时冷冻原发灶及转移灶),对照组23例(不冷冻或只冷冻转移灶),对术后不良反应进行观察,并比较两组患者中位生存期。结果所有冷冻组患者手术都顺利进行,氩氦刀冷冻术中、术后未发现心搏骤停或呼吸衰竭等严重并发症。术后不良反应包括咯血、气胸、心动过缓、术后低血压、发热、血小板减少和咳嗽。全面冷冻组患者生存时间(中位生存期14个月)显著长于对照组(中位生存期7个月,P=0.0009)。全面冷冻组患者中接受多次冷冻的患者生存期(中位生存期18个月)长于接受单次冷冻的患者(中位生存期14个月,P=0.0376)。结论经皮全面冷冻术安全性较好并能显著延长Ⅳ期肺癌患者的生存期,多次全面冷冻对生存期的延长作用更加显著。
Objective To investigate the postoperative adverse reactions and curative effects of CT guided percutaneous freezing treatment of stage Ⅳ lung cancer. Methods A total of 54 patients with stage Ⅳ lung cancer who were admitted to Guangzhou Forte University Hospital from August 2004 to November 2011 were retrospectively analyzed. The patients were divided into three groups: 31 patients in the full-scale cryotherapy group (both primary and metastatic lesions), 23 Cases (no frozen or only frozen metastases), postoperative adverse reactions were observed, and the median survival of the two groups were compared. Results All the patients in the freezing group operated smoothly. In the argon-helium-knife cryosurgery, no serious complications such as cardiac arrest or respiratory failure were found after operation. Adverse reactions included hemoptysis, pneumothorax, bradycardia, postoperative hypotension, fever, thrombocytopenia and coughing. Survival time (median survival 14 months) was significantly longer in patients in the comprehensive freezer group than in the control group (median survival 7 months, P = 0.0009). Patients in the full-frozen group who received multiple injections had a longer survival (median survival 18 months) than patients who received single-freezing (median survival 14 months, P = 0.0376). Conclusion Percutaneous total freezing is safe and can significantly prolong the survival of patients with stage Ⅳ lung cancer. The effects of multiple full-scale freezing on the extension of survival are more significant.