论文部分内容阅读
目的:探讨125I粒子组织植入在难治性海绵血管瘤治疗中的可行性。方法:选择2005-01/2006-03长海医院整形外科收治的海绵血管瘤患者4例,经患者知情同意后行I粒子组织植入治疗,且得到医院伦理道德委员会批准。术前行CT/MRI或/和B型超声波检查,详细计算瘤体体积和所需处方剂量。植入粒子时应该避开神经,距离应大于17mm为宜。放射性粒子采用中国原子能科学院生产的外形为圆柱状钛合金封体的125I放射粒子源(批号:国药准字H20045969),长4.5mm,直径0.8mm,平均能量27～35keV,半衰期60.1d,半价层0.025mmPb,组织穿能力为1.7cm。术中经皮组织间永久植入125I粒子,粒子以1.5～2.0cm的间距均匀排布于血管瘤组织中。术后应用CT/MRI检查血管瘤的体积变化,应用X射线检查有无粒子丢失或游走。结果:4例患者全部进入结果分析,无脱落。①全部病例共植入125I粒子97粒,平均24.25粒,其中最少20粒,最多30粒。粒子平均活度1.85×107Bq,共1.79×109Bq。②术中患者未见不良反应,术后血液学检查正常。③所有病例均获得随访,随访时间分别为10,12,14,24个月。随访期内CT/MRI检查可见肿瘤体积均有不同程度的缩小;肿瘤无复发,无明显放疗反应;X射线监测无粒子丢失或游走。结论:应用I粒子植入治疗血管瘤,具有操作简单、患者痛苦小、见效快等优点,初步结果满意,有望成为治疗血管瘤的新方法。
Objective: To investigate the feasibility of 125I seeds implantation in the treatment of refractory sponge hemangioma. Methods: Four patients with spontaneous hemangiomas admitted to the Department of Plastic Surgery, Changhai Hospital from January 2005 to March 2006 were selected and I Particle implantation was performed with the informed consent of the patients and approved by the hospital ethics committee. Preoperative CT / MRI or / and B ultrasonic examination, detailed calculation of the tumor volume and the required prescription dose. Nerve should be avoided when implanting particles, the distance should be greater than 17mm is appropriate. Radioactive particles using the Chinese Academy of Atomic Energy produced cylindrical titanium alloy seal 125I radioactive particle source (batch number: Zhunzi H20045969), length 4.5mm, diameter 0.8mm, the average energy of 27 ~ 35keV, half-life of 60.1d, half-price layer 0.025mmPb, tissue wear capacity of 1.7cm. Intraoperative percutaneous implantation of permanent 125I particles, the particles to 1.5 ~ 2.0cm spacing evenly arranged in the hemangioma tissue. Postoperative application of CT / MRI examination of the volume changes of hemangiomas, the application of X-ray examination for particle loss or wandering. Results: All four patients entered the result analysis without shedding. ① All cases were implanted with 97 seeds 125I particles, an average of 24.25, of which at least 20, up to 30. The average particle activity of 1.85 × 107Bq, a total of 1.79 × 109Bq. ② no intraoperative adverse reactions, postoperative hematological examination was normal. ③ All patients were followed up for 10, 12, 14 and 24 months respectively. During the follow-up period, CT / MRI showed that the tumor volume was reduced to varying degrees; the tumor had no recurrence and no obvious radiotherapy response; no X-ray was detected or missing. Conclusion: The application of I-particle implantation in the treatment of hemangiomas has the advantages of simple operation, little pain and quick response. The preliminary results are satisfactory and it is expected to become a new method for the treatment of hemangiomas.