Tajiri Nobuhisa, Hiraki Takao, Mimura Hidefumi, Gobara Hideo, Mukai Takashi, Hase Soichiro, Fujiwara Hiroyasu, Iguchi Toshihiro, Sakurai Jun, Aoe Motoi, Sano Yoshifumi, Date Hiroshi, Kanazawa Susumu
Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan.
Cardiovasc Intervent Radiol. 2008 May-Jun;31(3):581-6. doi: 10.1007/s00270-007-9283-3. Epub 2008 Jan 15.
The purpose of this study was to investigate the relationship between pleural temperature and pneumothorax or pleural effusion after radiofrequency (RF) ablation of lung tumors. The pleural temperature was measured immediately outside the lung surface nearest to the tumor with a fiber-type thermocouple during 25 ablation procedures for 34 tumors in 22 patients. The procedures were divided into two groups depending on the highest pleural temperature: P-group I and P-group II, with highest pleural temperatures of <40 degrees C and >/=40 degrees C, respectively. The incidence of pneumothorax or pleural effusion was compared between the groups. Multiple variables were compared between the groups to determine the factors that affect the pleural temperature. The overall incidence of pneumothorax and pleural effusion was 56% (14/25) and 20% (5/25), respectively. Temperature data in five ablation procedures were excluded from the analyses because these were affected by the pneumothorax. P-group I and P-group II comprised 10 procedures and 10 procedures, respectively. The incidence of pleural effusion was significantly higher in P-group II (4/10) than in P-group I (0/10) (p = 0.043). However, the incidence of pneumothorax did not differ significantly (p = 0.50) between P-group I (4/10) and P-group II (5/10). Factors significantly affecting the pleural temperature were distance between the electrode and the pleura (p < 0.001) and length of the lung parenchyma between the electrode and the pleura (p < 0.001). We conclude that higher pleural temperature appeared to be associated with the occurrence of pleural effusion and not with that of pneumothorax.
本研究旨在探讨肺肿瘤射频消融术后胸膜温度与气胸或胸腔积液之间的关系。在对22例患者的34个肿瘤进行的25次消融手术过程中，使用纤维型热电偶在最靠近肿瘤的肺表面外侧立即测量胸膜温度。根据最高胸膜温度将手术分为两组：P组I和P组II，最高胸膜温度分别<40℃和≥40℃。比较两组气胸或胸腔积液的发生率。比较两组之间的多个变量，以确定影响胸膜温度的因素。气胸和胸腔积液的总体发生率分别为56%（14/25）和20%（5/25）。5次消融手术的温度数据因受气胸影响而被排除在分析之外。P组I和P组II分别包括10次手术。P组II（4/10）胸腔积液的发生率显著高于P组I（0/10）（p = 0.043）。然而，P组I（4/10）和P组II（5/10）之间气胸的发生率没有显著差异（p = 0.50）。显著影响胸膜温度的因素是电极与胸膜之间的距离（p < 0.001）和电极与胸膜之间肺实质的长度（p < 0.001）。我们得出结论，较高的胸膜温度似乎与胸腔积液的发生有关，而与气胸的发生无关。
