探讨计算机断层扫描(computed tomography, CT)引导下微波消融与冷冻消融治疗肺结节及肺癌的有效性及安全性。

选择2018年7月至2023年10月我院收治的肺结节及肺癌患者49例，微波消融治疗26例为微波组，冷冻消融治疗23例为冷冻组。比较两组治疗后临床疗效、并发症、无进展生存率。

23例冷冻组患者肿瘤部位左侧5例(21.74%)、右侧18例(78.26%)，亚实性20例(86.96%)、实性3例(13.04%)，结节大小5~10 mm 5例(21.74 %)、>10 mm 18例(78.26 %)，病理类型良性15例(65.22%)、恶性8例(34.78%)，其中肺鳞癌1例(4.35%)、肺腺癌7例(30.43 %)。26例微波组患者肿瘤部位左侧12例(46.15%)、右侧14例(53.85%)，亚实性17例(65.38%)、实性9例(34.62%)，结节大小<5 mm 1例(3.85%)、5~10 mm 4例(15.38%)、>10 mm 21例(80.77%)，病理类型良性8例(30.77%)、恶性18例(69.23%)，其中肺鳞癌1例(3.85%)、肺腺癌15例(57.69 %)、肉瘤样癌1例(3.85%)、乳腺癌转移1例(3.85%)。冷冻组气胸1例(4.35%)、皮下少量积气1例(4.35%)、复发3例(13.04%)，无死亡病例；微波组气胸5例(19.23%)、胸腔积液1例(3.85%)、脓肿1例(3.85%)、远处转移1例(3.85%)、复发4例(15.38%)、死亡3例(11.54%)。

微波消融及冷冻消融对肺结节治疗安全有效，可作为除手术之外肺结节治疗选择方式。

To investigate the efficacy and safety of computed tomography(CT)-guided microwave ablation versus cryoablation in the treatment of pulmonary nodules and lung cancer.

A total of 49 patients with pulmonary nodules or lung cancer admitted to our hospital from July 2018 to October 2023 were selected. Twenty-six patients treated with microwave ablation comprised the microwave group, and 23 patients treated with cryoablation comprised the cryoablation group. Post-treatment complications and progression-free survival rates were compared between the two groups.

In the cryoablation group 23 cases, the tumor location was left-sided in 5 cases (21.74%) and right-sided in 18 cases (78.26%); nodules were subsolid in 20 cases (86.96%) and solid in 3 cases (13.04%); nodule size was <5 mm in 0 cases, 5~10 mm in 5 cases (21.74%), and >10 mm in 18 cases (78.26%); pathological types were benign in 15 cases (65.22%) and malignant in 8 cases (34.78%), including 1 case of lung squamous cell carcinoma (4.35%) and 7 cases of lung adenocarcinoma (30.43%). In the microwave group 26 cases, the tumor location was left-sided in 12 cases (46.15%) and right-sided in 14 cases (53.85%); nodules were subsolid in 17 cases (65.38%) and solid in 9 cases (34.62%); nodule size was <5 mm in 1 case (3.85%), 5~10 mm in 4 cases (15.38%), and >10 mm in 21 cases (80.77%); pathological types were benign in 8 cases (30.77%) and malignant in 18 cases (69.23%), including 1 case of lung squamous cell carcinoma (3.85%), 15 cases of lung adenocarcinoma (57.69%), 1 case of sarcomatoid carcinoma (3.85%), and 1 case of metastatic breast cancer (3.85%). In the cryoablation group, complications were: pneumothorax in 1 case (4.35%), subcutaneous emphysema in 1 case (4.35%), recurrence in 3 cases (13.04%), and death in 0 cases. In the microwave group, complications were: pneumothorax in 5 cases (19.23%), pleural effusion in 1 case(3.85%), abscess in 1 case (3.85%), distant metastasis in 1 case (3.85%), recurrence in 4 cases (15.38%), and death in 3 cases (11.54%).

Both microwave ablation and cryoablation are safe and effective for the treatment of pulmonary nodules and can be considered as treatment options in addition to surgery.