| 摘要: |
| 目的 探讨超声引导下液体隔离法的实施方法、技术要领及其在颈部结节性病变经皮热消融治疗中的应用价值。方法 2005年5月至2013年4月共对1 126例罹患颈部结节性病变的患者行超声引导下经皮射频或微波热消融治疗,消融时于超声引导下向病灶及其周围结构的潜在间隙内注射隔离液,形成隔离带,使拟消融的病灶与周围结构分离。回顾分析并总结液体隔离法在提升穿刺路径安全性、降低正常组织热损伤、提高病灶消融彻底性等方面的作用。结果 在甲状腺、甲状旁腺、颌下腺、淋巴结周围等14个部位成功实施了液体隔离法,总结出液体隔离法的技术要领和超声影像特征。与未采用液体隔离相比,液体隔离法能降低颈部结节病灶消融热损伤发生率(0.7% vs 15%, P<0.01),降低首次消融残余率(0.29% vs 7.4%, P<0.01)。结论 超声引导下液体隔离法实施简便,可重复性好,隔离效果确切,是颈部结节热消融治疗安全、有效的辅助措施。 |
| 关键词: 颈部结节状病变 热消融治疗 液体隔离法 超声引导 |
| DOI：10.3724/SP.J.1008.2014.01045 |
| 投稿时间：2014-01-15修订日期：2014-05-09 |
| 基金项目:国家自然科学基金(81171436). |
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| Application of hydro-dissection technique in percutaneous thermal ablation of neck nodular lesions |
| ZHANG Jian-quan*,SHENG Jian-guo,DIAO Zong-ping,ZHAO Lu-lu,ZHANG Hang |
(Department of Medical Ultrasound, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding authors) |
| Abstract: |
| Objective To introduce the hydro-dissection technique and its application in ultrasound-guided percutaneous thermal ablation therapy of neck nodular lesions. Methods A total of 1 126 patients suffering from neck nodular diseases received percutaneous thermal therapy using radiofrequency ablation or microwave ablation from May 2005 to April 2013. As a part of the treatment procedure, ultrasound-guided injection of separating liquid was performed into between the target nodules and surrounding structures to form a separating zone prior to ablation. The roles of hydro-dissection technique in improving the safety of puncture route, reducing the thermal injury to normal tissues, and enhancing the curative effects of ablation were analyzed. Results Hydro-dissection technique was successfully performed in as many as fourteen parts related to the thyroids, parathyroids, submandibular glands and lymph nodes. The key points and ultrasonic characteristics of this maneuver were well established and understood. Compared with those not receiving the technique, those receiving the technique had significantly reduced heat damage to lesion-adjacent structures (0.7% vs 15%, P<0.01) and decreased incomplete ablation rate of the first try (0.29% vs 7.4%, P<0.01). Conclusion Hydro-dissection technique under ultrasound-guidance is easy to perform, has good repeatability and reliable effect; it may serve as a safe and effective supplementary measure for thermal ablation of various neck nodular lesions. |
| Key words: neck nodular lesions thermal ablation therapy hydro-dissection ultrasound-guidance |
