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冷冻消融在治疗骨与软组织肿瘤中的应用

Application of cryoablation in bone and soft tissue tumors

摘要:

Freezing can cause damage to tissues by physical, chemical, and vascular effects. Cryoablation, mainly by its destructive freezing effects and tumor low temperature sensitivity, has become an important assistant cure method for bone and soft tissue tumors. In recent years, the argon-helium knife technology has been widely used in the treatment of distinctive highly malignant bone and soft tissue tumors, low-grade malignant and benign bone and soft tissue tumors and metastases of bone and soft tissue. The ifrst generation of freezing technology-direct dump soaking method, namely open liquid nitrogen refrigeration technique, has the downside of freezing temperature and freezing depth are dififcult to control, inaccurate, prone to insufifcient freezing or excessive freezing. The second generation of freezing technology-half open refrigeration technology, has the feature that liquid nitrogen vaporization is faster and leakage can be prevented, refrigeration is stronger, cooling time is easier to control. The modern refrigeration technology, argon-helium knife, is a new method for tumor treatment, approved by the FDA in 1999, by the Chinese SFDA in 1998, is a signiifcant reform of the freezing technology. It can kill turmor cells by quick feeezing and fast warming, with the advantages of minimally invasive, higher controllability. Cryoablation may cause several kinds of complications, such as cold shock, tumor lysis syndrome, hemorrhage, infection, air embolism, fracture, surrounding soft tissue frostbite. A preliminary consensus in the application of cryoablation already formed for bone and soft tissue tumor, but there is still controversy. Compared with the classical treatment, cryoablation has unique advantages and good safety, and anticipated curative effect, it is expected to achieve long-term disease control as well as symptomatic relief, but still faces many technical bottlenecks. This article makes a summary on the application history, menchnism, current application, operational approach, complications and preventive measures, consensus and controversy, trends and future prospects.

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