刘辉来 文自祥

[摘要]目的分析數字减影血管造影（DSA）三维重建技术引导射频消融治疗肺恶性肿瘤的临床应用。方法选取2019年1月至2021年4月中山市人民医院介入医学科收治的肺恶性肿瘤患者96例，根据治疗方法不同分为对照组和研究组，各48例，对照组实施 CT 引导下的射频消融术进行治疗，研究组实施 DSA 三维重建技术引导射频消融进行治疗，观察两组患者临床指标、生活质量水平及术后并发症发生情况。结果研究组患者在血清癌胚抗原（CEA）、白细胞计数（WBC）、血小板计数（PLT）、白介素-6（IL-6）以及肿瘤坏死因子（TNF）等临床指标情况明显高于对照组，差异有统计学意义（ P <0.05）;研究组患者干预后生活质量水平显著高于对照组，差异有统计学意义（ P <0.05）;研究组患者胸腔积液、气胸、肺部感染以及心包积液等术后并发症发生率显著低于对照组，差异有统计学意义（ P <0.05）。结论对肺恶性肿瘤患者实施 DSA 三维重建技术引导射频消融进行治疗，可很好地改善患者临床各项生理指标，提高患者生活质量水平，降低患者术后并发症发生率，促进患者快速康复。

[关键词]肺恶性肿瘤; DSA 三维重建;射频消融术;并发症;生活质量

[中图分类号] R734.2;R730.55  [文献标识码] A   [文章编号]2095-0616（2021）23-0162-04

Clinical  application  of radiofrequency  ablation  guided  by threedimensional digital subtraction angiography in the treatment of pulmonary malignancy

LIU  Huilai    WEN  Zixiang

Department ofInterventional Medicine， the People's Hospital ofZhongshan City， Guangdong， Zhongshan 528400， China

[Abstract] Objective To analyze the clinical application of radiofrequency ablation guided by threedimensional digital subtraction angiography （3D-DSA） in the treatment of pulmonary malignancy. Methods A total of 96 patients with pulmonary malignancy admitted to the Department of Interventional Medicine of the People's Hospital of Zhongshan City from January 2019 to April 2021 were selected as research objects. They were divided into the control group and the study group according to different treatment methods， with 48 cases in each group. The control group was treated with CT-guided radiofrequency ablation， while the study group was treated with 3D-DSA-guided radiofrequency ablation. Clinical indicators， quality of life and postoperative complications of the two groups were observed. Results The levels of carcinoembryonic antigen （CEA）， white cell count （WBC）， platelet count （PLT）， interleukin-6（IL-6） and tumor necrosis factor （TNF） in the study group were significantly higher than those in the control group， with statistically significant differences（P <0.05）. After intervention， the quality of life in the study group was significantly higher than that in the control group， with statistically significant difference （P <0.05）. The incidence of postoperative complications such as pleural effusion， pneumothorax， pulmonary infection and pericardial effusion in the study group was significantly lower than that in the control group， with statistically significant difference （P <0.05）. Conclusion 3D-DSA-guided radiofrequency ablation can improve the clinical physiological indexes of patients， improve their quality of life， reduce the incidence of postoperative complications and promote their rapid recovery.

[Key words] Pulmonary malignancy; Threedimensional digital subtraction angiography; Radiofrequency ablation; Complication; Quality of life

肺恶性肿瘤是肺部腺体或支气管黏膜上皮组织发生病理性改变的呼吸内科系统疾病，常表现为间断式刺激性干咳、痰液中带有血性分泌物以及气喘局限性哮鸣音等症状，随着癌细胞的扩散转移，还会引发中枢神经系统障碍、病理性骨折以及细菌性心内膜炎等并发症，不仅影响患者的日常行为生活，严重时还会对患者生命安全造成一定威胁[1]。射频消融术是较为新型的微创治疗手段，通过影像学技术引导方式，对患者局部癌肿组织进行介入治疗，成为肺恶性肿瘤临床治疗首选[2]。因此，选取较为先进、疗效较为显著的影像学技术引导十分关键。数字减影血管造影（digital subtraction angiography， DSA）三维重建技术与 CT 技术相比，因其成像清晰、操作便捷等优势，大大提高了患者临床治疗的安全性，广泛应用于恶性肿瘤系统疾病临床治疗领域[3]。……