53
Τᔼਖ਼ஞ
4.
治療的適應症有所不同：
氬氦刀無法治療包
圍這些腔道的腫瘤，例如包繞氣管，腸管等；
而納米刀則無這方面的禁忌症，但是納米刀無
法使用於腫瘤附近植入了金屬、心律失常及近
期有心肌梗塞的病人。
5.
治療探針的區別：
射頻消融治療單根電極外
徑約
2
毫米；氬氦刀探針約
1.47
毫米；納米刀的
探針直徑最小，只有
1
毫米。但是相對穿刺的創
傷而言，射頻消融由於只是插入單針應該算最
小；而納米刀雖然探針只是
1
毫米但是可能需要
多次穿刺因而可能創傷稍微大一點；氬氦刀一
般都是多針組合，創傷又會稍微大一些。但是
這些治療都是非常微創的治療，只是穿刺進行，
術後恢復都差不多快。
5
公分以內的腫瘤
1–3
天
就可以出院。
納米刀「作為一項全新的腫瘤消融治療技術，它剛開
始應用於臨床，是否有介紹中說的那麼好還需要至
少五年時間的臨床驗證。因此該技術很難替代射頻
消融及冷凍消融 」。因為射頻消融及冷凍消融使用方
便，麻醉簡單一些而且價格適中。目前國內已經審
批通過該納米電消融技術，希望該技術能造福於腫
瘤患者，尤其是病變部位關鍵的患者並達到理想的
治療效果。因為無論是氬氦刀，射頻消融還是微波
消融都可能存在治療盲區，這個盲區希望能通過納
米刀解決，甚至超過手術刀效果，這才是這項技術
的目的。
ˬͭқબᔊʧ
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China’s First Successful Implementation of NanoKnife Treatment for Pancreatic Cancer: An
Interview with Director Niu LiZhi of the Guangzhou Fuda Cancer Hospital.
Irreversible electroporation (IRE), or a non-thermal irreversible electroporation) is a soft tissue ablation technique using highly
localized “ultrashort” and strong electrical fields to create permanent and hence lethal “nanopores” (nano-size perforations) in the
cell membrane, to disrupt the cellular homeostasis (delicate internal environment mandatory for cell function). The resulting cell
death results from “apoptosis” rather than “necrosis” (cell death due to excessive heat or cold). Because precise mapping of the target
is feasible through meticulous placing of electrodes, it may be particularly useful to ablate cancers in close proximity to important
anatomical structures. The technique is in an experimental stage; approval has been granted, e.g., the US Food & Drug Administration
(FDA) has granted Investigational Device Exemption approval to conduct a clinical study of the NanoKnife System of AngioDynamics,
New York. During application, a general anaesthesia is mandatory, especially as the abdominal wall is cut open and a combination
of electrodes placed most meticulously into the cancer under ultra-sound guidance. For China’s first was in Guangzhou (a small
pancreatic cancer), a few quick bursts of energy was delivered in several minutes: less anaesthesia time, yet, ions enter the targeted
cells to kill.
