Research advances in perioperative care for pulmonary nodule ablation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Maodan ¹ , DENG Qian ¹ , ZHANG Suting ¹ , NIU Lingli ² , ZHU Yunke ² ,  SHEN Cheng ²

1. Department of Thoracic Surgery, Shangjin Hospital of West China Hospital, Sichuan University/Chengdu Shangjin Nanfu Hospital, Chengdu, 611743, P. R. China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding?author：

SHEN Cheng, Email: shencheng568_hx@163.com

Keywords：

Pulmonary nodule; ablation therapy; perioperative care; complication management; minimally invasive therapy; respiratory training; follow-up management; multidisciplinary assistance

DOI：

10.7507/1007-4848.202604022

Video：

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Ablation therapy for pulmonary nodules is increasingly utilized as a crucial minimally invasive intervention for early lung cancer, yet a unified standard for its perioperative nursing care remains elusive. This review systematically synthesizes the essential aspects and recent advancements in perioperative nursing for pulmonary nodule ablation, aiming to provide evidence-based guidance for clinical practice. Through a comprehensive literature review from January 2023 to April 2026 across databases including CNKI, Wanfang, VIP, and PubMed, we identify that optimal perioperative nursing should integrate across the entire patient management continuum: preoperative care emphasizes comprehensive assessment, psychological counseling, and breathing and breath-holding training; intraoperative care focuses on environment and equipment preparation, patient positioning, vital sign monitoring, operational assistance, and emergency response; and postoperative care is centered on vigilant condition observation, meticulous management of common complications such as pneumothorax, hemorrhage, pain, and fever (with particular attention to skin frostbite in cryoablation), health education, and stratified follow-up. Differences in nursing considerations for various ablation modalities, including radiofrequency, microwave, and cryoablation, are also discussed. Evidence suggests that implementing standardized and holistic perioperative nursing significantly reduces complication risks, enhances patient recovery, and is vital for ensuring the safety and efficacy of ablation therapy. Future improvements should actively incorporate information-based follow-up, artificial intelligence for risk assessment, and multidisciplinary collaboration models to further elevate nursing quality and improve long-term patient prognoses.

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1. 赫捷, 李霓, 陳萬青, 等. 中國肺癌篩查與早診早治指南 (2021, 北京)[J]. 中國腫瘤, 2021, 30(2): 81-111.He J, Li N, Chen WQ, et al. China guideline for the screening and early detection of lung cancer (2021, Beijing)[J]. Chin J Cancer, 2021, 30(2): 81-111.
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3. 中華人民共和國國家衛生健康委員會. 肺癌篩查與早診早治方案 (2024年版). 全科醫學臨床與教育, 2024, 22(9): 772, 776.National Health Commission of the People's Republic of China. Lung cancer screening and early diagnosis and treatment plan (2024 edition). Clin Educ Gen Pract, 2024, 22(9): 772, 776.
4. 中華醫學會呼吸病學分會, 中國肺癌防治聯盟專家組. 肺結節診治中國專家共識 (2024年版)[J]. 中華結核和呼吸雜志, 2024, 47(8): 716-729.Chinese Thoracic Society, Chinese Medical Association; Chinese Alliance Against Lung Cancer Expert Group. Chinese expert consensus on diagnosis and treatment of pulmonary nodules (2024)[J]. Chin J Tuberc Respir Dis, 2024, 47(8): 716-729.
5. 葉欣, 范衛君, 王忠敏, 等. 熱消融治療肺部亞實性結節專家共識 (2021年版)[J]. 中國肺癌雜志, 2021, 24(5): 305-322.Ye X, Fan WJ, Wang ZM, et al. Expert consensus for thermal ablation of pulmonary subsolid nodules (2021 edition)[J]. Chin J Lung Cancer, 2021, 24(5): 305-322.
6. 高倩, 陸霓虹, 楊艷. CT引導下經皮微波消融肺結節: 安全性、療效與并發癥研究進展[J]. 結核與肺部疾病雜志, 2026, 7(2): 262-267.Gao Q, Lu NH, Yang Y. Percutaneous microwave ablation of pulmonary nodules under CT guidance: study progress of safety, effectiveness and complication[J]. Chin J Tuberc Lung Dis, 2026, 7(2): 262-267.
7. Chen L, Xie X, Li K, et al. Analysis of perioperative risk factors and development of predictive models for complications following CT guided microwave ablation of pulmonary nodules[J/OL]. Sci Rep, 2025, 15(1): 33770. DOI: 10.1038/s41598-025-98636-2.
8. 任秀紅, 李孝紅, 曹海藍, 等. 影像引導肺部腫瘤微波消融術圍術期護理專家共識[J]. 護理研究, 2025, 39(18): 3025-3032.Ren XH, Li XH, Cao HL, et al. Expert consensus on perioperative care of lung tumor patients image-guided microwave ablation[J]. Nurs Res, 2025, 39(18): 3025-3032.
9. 劉寶東, 陳海泉, 劉倫旭, 等. 肺結節多學科微創診療中國專家共識[J]. 中國胸心血管外科臨床雜志, 2023, 30(8): 1061-1074.Liu BD, Chen HQ, Liu LX, et al. Chinese expert consensus on multidisciplinary minimally invasive diagnosis and treatment of pulmonary nodules[J]. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(8): 1061-1074.
10. 董家齊. 能譜CT對于肺結節射頻消融早期治療效果的評估[D]. 成都醫學院, 2024.Dong JQ. Evaluation of the early therapeutic effect of radiofrequency ablation of pulmonary nodules by energy spectrum CT[D]. Chengdu Medical College, 2024.
11. Páez-Carpio A, Gómez FM, Isus Olivé G, et al. Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art[J]. Insights Imaging, 2021, 12(1): 57.
12. 劉玲, 高寶安, 魯明騫, 等. 微波消融治療惡性肺結節進展[J]. 中國介入影像與治療學, 2022, 19(10): 657-660.Liu L, Gao BA, Lu MQ, et al. Advances in microwave ablation of malignant pulmonary nodules[J]. Chin J Interv Imaging Ther, 2022, 19(10): 657-660.
13. 趙應鼎, 薛天天, 李邦勝, 等. 消融術治療非小細胞肺癌的研究進展[J]. 現代腫瘤醫學, 2025, 33(7): 1216-1225.Zhao YD, Xue TT, Li BS, et al. Research advances in ablation therapy for non-small cell lung cancer[J]. J Mod Oncol, 2025, 33(7): 1216-1225.
14. Wang N, Xu J, Ma J, et al. Risk factors and immune landscape of early local tumor progression after microwave ablation for lung cancer: a retrospective nested case-control study[J/OL]. Front Immunol, 2026, 17: 1767345. DOI: 10.3389/fimmu.2026.1767345.
15. 沈旭, 沈誠, 肖叢佳, 等. 多發肺結節消融治療的研究進展[J]. 中國胸心血管外科臨床雜志, 2025, 32(3): 401-405.Shen X, Shen C, Xiao CJ, et al. Progress in ablation therapy of pulmonary nodules[J]. Chin J Clin Thorac Cardiovasc Surg, 2025, 32(3): 401-405.
16. Fish AG, Madoff DC. Advances in percutaneous lung ablation: techniques, outcomes, and future directions-a literature review[J]. Chin Clin Oncol, 2026, 15(1): 10.
17. 張肖, 肖越勇, 李成利. 影像學引導下肺結節冷凍消融專家共識 (2022版)[J]. 中國介入影像與治療學, 2022, 19(1): 2-6.Zhang X, Xiao YY, Li CL. Expert consensus for image-guided cryoablation of pulmonary nodule (2022 edition)[J]. Chin J Interv Imaging Ther, 2022, 19(1): 2-6.
18. Guo Y, Yan J, Yang M, et al. Efficacy of argon-helium cryoablation combined with chemotherapy in the treatment of advanced NSCLC[J]. Pak J Med Sci, 2024, 40(9): 2017-2021.
19. 馬銳. CT引導下經皮肺癌微波消融術的護理[J]. 影像研究與醫學應用, 2020, 4(15): 241-242.Ma R. Nursing care of CT-guided percutaneous microwave ablation for lung cancer[J]. J Imaging Res Med Appl, 2020, 4(15): 241-242.
20. 楊成靜. CT引導下經皮微波消融治療肺部惡性腫瘤患者的護理體會[J]. 中國社區醫師, 2022, 38(23): 136-138.Yang CJ. Nursing experience of CT-guided percutaneous microwave ablation in treatment of patients with malignant lung tumor[J]. Chin Commun Doctors, 2022, 38(23): 136-138.
21. 杜麗麗, 王璇, 黃寧寧, 等. 正確的呼吸配合與降低CT引導肺癌消融術并發癥的護理觀察[J]. 中國婦幼健康研究, 2016, 27(S1): 459.Du LL, Wang X, Huang NN, et al. Nursing observation on correct breathing cooperation and reducing complications of CT-guided lung cancer ablation[J]. Chin J Woman Child Health Res, 2016, 27(S1): 459.
22. 陳霞. CT引導下經皮肺癌微波消融術的護理[J]. 天津護理, 2018, 26(2): 191-192.Chen X. Nursing care of CT-guided percutaneous microwave ablation for lung cancer[J]. Tianjin J Nurs, 2018, 26(2): 191-192.
23. 劉淑慧, 方善春, 湯曉明, 等. CT引導下肺結節微波消融術的護理配合[J]. 臨床護理研究, 2022, 6(14): 172-174.Liu SH, Fang SC, Tang XM, et al. CT-guided microwave ablation of pulmonary nodules[J]. Chin Nurs Res, 2022, 6(14): 172-174.
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