[目的]探讨经皮穿刺氩氦刀靶向治疗肺部肿瘤的临床疗效和安全性。[方法]采用CT引导,对725例肺部肿瘤患者及其816个病灶行经皮穿刺氩氦刀靶向冷冻消融治疗。动态观察肺部肿瘤治疗前后胸部CT、18F-FDG和经皮肺穿刺病理活检等变化、并发症和生存率。[结果]直径<4cm的435个肺内肿块,冰球覆盖肿瘤面积达96%,显效率达97%;直径>4cm的381个肿块,冰球覆盖肿瘤面积为82%,显效率为68%。手术过程安全,无一例死亡。术后患者未发生严重并发症,仅出现少量咯血约占38%,发热35%,气胸25%,胸腔积液6%等轻微副作用,经对症处理可恢复正常。术后1周左右CT影像特征可见肿瘤区域阴影增大,多呈蜂窝空洞样破坏,CT值较冷冻前降低。FDG肿瘤显像示瘤体局部异常放射性浓聚影明显减少。术后3～12个月复查CT示肿瘤明显缩小,部分患者肿瘤消失。肺活检结果显示,术后1个月内肿瘤细胞呈凝固性坏死,3个月后可逐渐吸收或纤维化改变。术后随访0.5年、1年、2年和3年,患者生存率分别为91%、76%、36%和18%,中位生存时间17.8个月。[结论]CT引导下经皮穿刺氩氦刀靶向治疗肺部肿瘤是一种有效、安全的治疗方法,并发症少而轻微。该方法尤其适用于不能手术切除或难于耐受手术,或其他疗法治疗失败的恶性肺部肿瘤患者。 [Objective] To investigate the clinical efficacy and safety of percutaneous puncture of cryoablation for lung cancer. [Method] With CT guidance, 725 pulmonary tumor patients and 816 lesions were treated by percutaneous argon-helium cryoablation. Dynamic changes of chest CT, 18F-FDG and pathological biopsy of percutaneous pulmonary puncture before and after treatment of lung cancer were observed. Complications and survival rates were also observed. [Result] There were 435 intrapulmonary masses with a diameter less than 4 cm. The area covered by the iceball was 96% and the effective rate was 97%. There were 381 tumors with a diameter of 4cm. The area covered by the iceball was 82% and the effective rate was 68%. Surgical safety, no one died. Postoperative patients without serious complications, only a small amount of hemoptysis accounted for about 38%, 35% fever, pneumothorax 25%, 6% pleural effusion and other minor side effects, the symptomatic treatment can return to normal. About 1 week after operation, the shadow of CT showed that the shadow of the tumor area increased and the cells were almost destroyed by honeycomb cavity. The CT value was lower than that before freezing. FDG tumor imaging showed abnormal local tumor concentration decreased significantly. After 3 to 12 months of review CT showed significantly reduced tumor, some patients disappeared. Lung biopsy results show that within 1 month after the tumor cells were coagulative necrosis, 3 months after gradual absorption or fibrosis change. Patients were followed up for 0.5 years, 1 year, 2 years and 3 years. Survival rates were 91%, 76%, 36% and 18%, respectively. The median survival time was 17.8 months. [Conclusion] The CT guided percutaneous argon-helium cryoablation is an effective and safe treatment for lung tumors with few and minor complications. This method is particularly suitable for patients with malignant lung tumors that can not be surgically removed or are refractory to surgery, or failed in other therapies.