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目的 :探讨可弯曲穿刺针在肝脏肿瘤乙醇注射消融 (PEI)中的使用方法及应用价值。方法 :18个 <5 cm的肝脏恶性肿瘤应用可弯曲穿刺针行 PEI。对位置深或中心层面穿刺途径中有门脉、胆管阻挡常规穿刺针不易穿中的小病灶 ,首先将外套针穿至病灶旁 ,再通过外套针将可弯曲细针的弯曲方向对准病灶并穿入病灶内 ,注入适量乙醇 ;对较大病灶通过改变弯针的方向在病灶内多点注射乙醇。结果 :18个肝脏肿瘤经≥ 2次 PEI,乙醇弥散区均覆盖全部病灶。 3个月后 CT多期扫描或增强MRI复查 ,≤ 3cm的肿瘤完全坏死 10个、大部坏死 2个 ,>3cm的肿瘤中完全坏死 4个 ,大部坏死 2个 ,部分患者血清肿瘤标志物水平显著下降。 结论 :使用可弯曲穿刺针行肝脏肿瘤 PEI操作方便、效果良好 ,可作为常规穿刺针的重要补充。
Objective: To explore the method of using flexible puncture needle in hepatic tumor ethanol injection ablation (PEI) and its application value. METHODS: Eighteen <5 cm liver malignancies were treated with a flexible puncture needle for PEI. On the deep or central level puncture pathway in the portal vein, bile duct blocking conventional puncture needle is not easy to wear in the small lesions, first coat the needle to the lesion, and then through the jacket needle bending direction of flexible fine needle alignment and Into the lesion, the amount of ethanol injected; larger lesions by changing the direction of the looper in the lesion injections of ethanol. Results: All 18 lesions of liver tumors were covered by ≥2 PEI and alcohol diffusion zone. After 3 months CT multi-phase scan or enhanced MRI review, ≤ 3cm tumor completely necrosis 10, most of the necrosis 2,> 3cm tumor completely necrotic 4, most of the necrosis 2, some patients with serum tumor markers The level dropped significantly. Conclusion: PEI is a convenient and effective method for the treatment of liver tumors by using flexible puncture needle. It can be used as an important supplement to conventional puncture needle.