气管内超声引导纵隔肿瘤激光多点消融操作流程

doi:10.11958/20231611

天津医药 ›› 2024, Vol. 52 ›› Issue (1): 80-82.doi: 10.11958/20231611

气管内超声引导纵隔肿瘤激光多点消融操作流程

刘丹(), 万南生, 王杰, 李广生, 谢巍, 田羽, 冯靖^△()

天津医科大学总医院呼吸与危重症医学科（邮编300052）

收稿日期:2023-10-31 出版日期:2024-01-15 发布日期:2024-01-18
通讯作者: ^△E-mail：zyyhxkfj@126.com
作者简介:刘丹（1989），女，主治医师，主要从事睡眠呼吸暂停、介入呼吸病学方面研究。E-mail：liudan_nkdx@163.com
基金资助:
天津市“131”创新型人才团队建设项目(201940)

Standard operating procedure for endobronchial ultrasound guided laser multi-point ablation of mediastinal tumors

LIU Dan(), WAN Nansheng, WANG Jie, LI Guangsheng, XIE Wei, TIAN Yu, FENG Jing^△()

Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China

Received:2023-10-31 Published:2024-01-15 Online:2024-01-18
Contact: ^△E-mail：zyyhxkfj@126.com

刘丹, 万南生, 王杰, 李广生, 谢巍, 田羽, 冯靖. 气管内超声引导纵隔肿瘤激光多点消融操作流程[J]. 天津医药, 2024, 52(1): 80-82.

LIU Dan, WAN Nansheng, WANG Jie, LI Guangsheng, XIE Wei, TIAN Yu, FENG Jing. Standard operating procedure for endobronchial ultrasound guided laser multi-point ablation of mediastinal tumors[J]. Tianjin Medical Journal, 2024, 52(1): 80-82.

摘要/Abstract

摘要：

由于纵隔解剖位置复杂，重要脏器较多，纵隔肿瘤的治疗一直是临床难点。相比传统局部治疗，气道内超声引导纵隔肿瘤激光多点消融具有较多优势，包括消融范围及效果可实时监控、避免损伤正常组织、不良反应少、耐受性好等。该文阐述了气管内超声引导纵隔肿瘤激光多点消融的操作流程。

关键词: 导管消融术, 支气管镜, 纵隔肿瘤, 气道内超声引导激光消融

Abstract:

The treatment of mediastinal tumor has always been a clinical difficulty due to its complex anatomical location and many important organs. Compared with traditional local treatment, endobronchial ultrasound guided laser multi-point ablation of mediastinal tumors has many advantages, including real-time monitoring of ablation range and effect, avoidance of damage to normal tissue and organs, few side effects and good tolerance. This article describes the standard operating procedure for endobronchial ultrasound guided laser multi-point ablation of mediastinal tumors.

Key words: catheter ablation, bronchoscopes, mediastinal neoplasms, endobronchial ultrasound guided laser ablation

中图分类号:

R564

图/表 6

图1 EBUS视野可见消融光纤趋于向前发射能量

Fig.1 The EBUS field of view showing ablation fiber tends to emit energy forward

图2 消融中心出现较明显焦化空洞，形成EBUS超声视野盲区

Fig.2 An obvious coking cavity appeared in the ablation center，forming a blind spot in the EBUS ultrasound field of view

图3 EBUS视野可见光纤端点紧邻血管

Fig.3 The EBUS field of view showed that the fiber endpoint was close to the blood vessel

图4 消融术中EBUS对能量分布与新增高回声区域的监测

Fig.4 EBUS monitoring of energy distribution and new hyperechoic areas during ablation

图5 调整镜身与EBUS视野，使光纤端点位于EBUS视野中部

Fig.5 Adjusted the lens body and EBUS field of view so that the fiber endpoint was in the middle of the EBUS field of view

图6 EBUS视野内可见两个新增高回声消融中心

Fig.6 After multi-point laser ablation，two new hyperechoic ablation centers could be seen in the EBUS field of view

参考文献 6

[1]	DUWE B V, STERMAN D H, MUSANI A I. Tumors of the mediastinum[J]. Chest, 2005, 128(4):2893-2909. doi:10.1378/chest.128.4.2893.
[2]	COZZI S, ALÌ E, BARDOSCIA L, et al. Stereotactic Body Radiation Therapy (SBRT) for oligorecurrent/oligoprogressive mediastinal and hilar lymph node metastasis:a systematic review[J]. Cancers (Basel), 2022, 14(11):2680. doi:10.3390/cancers14112680.
[3]	THEELEN W S M E, CHEN D, VERMA V, et al. Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer:a pooled analysis of two randomised trials[J]. Lancet Respir Med, 2021, 9(5):467-475. doi:10.1016/S2213-2600(20)30391-X.
[4]	国家卫计委海峡两岸医药卫生交流协会呼吸病学专业委员会, 中华医学会结核病学分会呼吸内镜专业委员会, 中国医师协会儿科学分会内镜专业委员会(筹), 等. 诊断性介入肺脏病学快速现场评价临床实施指南[J]. 天津医药, 2017, 45(4):441-448.
	Cross-Straits Medical Exchange Association, Chinese Medical Association, Chinese Medical Doctor Association, et al. Clinical guidance for diagnostic interventional pulmonary rapid on-site evaluation[J]. Tianjin Med J, 2017, 45(4):441-448. doi:10.11958/20170320.
[5]	冯靖, 刘丹, 万南生, 等. 导向注药套管经鼻悬吊留置伴或不伴锚定治疗肺部霉菌病的操作流程[J]. 天津医药, 2024, 52(1):83-86.
	FENG J, LIU D, WAN N S, et al. Standard operating procedure of the indwelling nasal cannula with or without anchoring for the treatment of pulmonary mycosis[J]. Tianjin Med J, 2024, 52(1):83-86. doi:10.11958/20231155.
[6]	冯靖, 石瑜. 气管内超声引导建隧活检术及规范操作要点[J]. 天津医药, 2021, 49(6):633-635.
	FENG J, SHI Y. EBUS-TDB,endobronchial ultrasound guided tunnel-drilling biopsy[J]. Tianjin Med J, 2021, 49(6):633-635. doi:10.11958/20210657.

[1]	冯靖, 刘丹, 万南生, 王杰, 句仁华, 谢巍, 田羽. 导向注药套管经鼻悬吊留置伴或不伴锚定治疗肺部霉菌病的操作流程[J]. 天津医药, 2024, 52(1): 83-86.
[2]	崔松勤, 黄红芳, 黄雪莲, 芮骁, 黄赛赛. 地佐辛联合不同剂量右美托咪定用于OSAHS患者经鼻清醒插管的效果比较[J]. 天津医药, 2022, 50(7): 775-779.
[3]	王宏杰, 邹映雪, 穆世茵, 郭永盛. 儿童肺结核45例临床特点及诊断分析[J]. 天津医药, 2022, 50(12): 1316-1319.
[4]	冯靖, 石瑜. 气管内超声引导建隧活检术及规范操作要点 #br#[J]. 天津医药, 2021, 49(6): 633-635.
[5]	陶梅梅, 张楠, 邹珩, 周云芝, 马洪明, 高鸿, 王洪武△. 气管支气管腺样囊性癌的影像学、支气管镜及快速现场评价的特征分析 #br#[J]. 天津医药, 2020, 48(5): 430-433.
[6]	冯靖 1，吴波 2，张静 3，李彩丽 1. 两性霉素 B经支气管镜肺部局部注入的理论依据和操作流程[J]. 天津医药, 2019, 47(4): 365-367.
[7]	郭伟, 张同强, 徐勇胜, 刘福军. 儿童肺炎支原体肺炎肺泡灌洗液中细胞因子分析[J]. 天津医药, 2018, 46(6): 648-651.
[8]	姜楠. 2017年房颤指南心脏外科相关内容解读[J]. 天津医药, 2018, 46(5): 497-498.
[9]	廖江荣, 王黔宇, 姜蓬. 经支气管镜植入放射性 125I粒子治疗中央型肺癌合并肺不张的疗效观察[J]. 天津医药, 2018, 46(3): 277-279.
[10]	刘乐乐，王国文△，韩秀鑫，张超，任志午，李丽丽，许尧. 射频消融辅助开放性手术治疗肾透明细胞癌脊柱转移的临床疗效[J]. 天津医药, 2018, 46(11): 1176-1180.
[11]	赵亚萍，王娟，谢巍，张鹏，冯靖，董丽霞，曹洁. 虚拟内镜、GS 外周超声探头联合快速现场评价对孤立性肺结节的诊断价值[J]. 天津医药, 2017, 45(9): 925-930.
[12]	赵勇，李冠华，赵晓赟，李月川△. 易误诊为肺癌的支气管异物 20 例报告[J]. 天津医药, 2017, 45(4): 406-408.
[13]	张永祥，贾玮，李月川，张冬睿，马晖. 氩等离子体凝固术在支气管镜活检后止血中的应用[J]. 天津医药, 2016, 44(4): 494-496.
[14]	李雅洁，谢巍，张鹏，薛艳超，冯靖△，曹洁△. 超细支气管镜、 DP 电子导航、 GS 外周超声小探头、玫瑰系统联合评价外周（1/3）肺感染性病灶的价值[J]. 天津医药, 2016, 44(1): 9-13.
[15]	薛卉，邢丽华，张彩莲，秦超，张东，杜钟珍. 支气管结核误诊92 例临床特征及内镜价值分析[J]. 天津医药, 2015, 43(12): 1420-1424.

气管内超声引导纵隔肿瘤激光多点消融操作流程

Standard operating procedure for endobronchial ultrasound guided laser multi-point ablation of mediastinal tumors

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