目的：探讨CT靶向引导下氩氦刀治疗中晚期肺癌的临床应用及并发症分析。方法64例经临床及组织病理学证实的中晚期肺癌，中心型24例，周围型40例，共17例并发肺门及或纵膈淋巴结转移。先行CT靶向引导，确定病灶最佳穿刺深度及角度后，行CT引导下氩氦刀冷冻治疗。结果64例均成功实施氩氦刀冷冻治疗，58例1次穿刺成功，6例两次穿刺成功。术后随访3～18个月，有效率87.5%，其中CR 20例(31.2%)， PR 28例(43.8%)，NC 8例(12.5%)，PD 8例(12.5%)。56例出现不良反应(87.5%)，但无严重并发症发生，其中发热22例(34.4%)，局部疼痛18例(28.1%)，气胸10例(15.6%)，胸腔积液6例(9.4%)，经对症治疗后好转。结论 CT靶向引导氩氦刀治疗中晚期肺癌具有定位准确，严重并发症少等优点，能有效提高中晚期肺癌患者的生存质量。%Objective To explore the clinical applications and complications of CT-target guided argon-helium cryosurgery in the treatment of intermediate and advanced lung cancer . Methods 64 sufferers with intermediate and ad-vanced lung cancer confirmed by clinic and histopathology were selected , among whom 24 cases were centre type , 40 were peripheral type , and altogether 17 of them had complications of pulmonary hilar or mediastinum lymphatic metas-tasis . They were CT-target guided first to determine the the best puncture depth and angle , then were performed CT-tar-get guided argon-helium cryoablation . Results 64 cases were successfully treated with argon-helium cryoablation , a-mong which 58 cases with 1 puncture and 6 cases with 2 punctures . The follow-up visits of 3 to 18 months showed the effective rate was 87 . 5%, 20 cases of CR ( 31 . 2%) , 28 cases of PR ( 43 . 8%) , 8 cases of NC ( 12 . 5%) , and 8 cases of PD ( 12 . 5%) . 56 cases showed adverse reaction ( 87 . 5%) but without severe complications , among which there were 20 cases of fever ( 34 . 4%) , 18 cases of local pain ( 28 . 1%) , 10 cases of pneumatothorax ( 15 . 6%) and 6 cases of hydrothorax ( 9 . 4%) , and all improved after symptomatic treatment . Conclusion CT-target guided argon-helium cryosurgery in the treatment of intermediate and advanced lung cancer bears the advantages of accurate location and few severe complica-tions , which can improve the sufferers' quality of life .
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