不可逆电穿孔是基于高强度短脉冲电场的非热消融技术，近年来在复杂部位肿瘤治疗中备受关注。对于毗邻重要血管、胆道、神经等关键结构的肿瘤，传统手术创伤大、风险高，热消融则受热损伤及热沉效应影响，疗效与安全性受限。而IRE通过诱导细胞膜不可逆损伤清除局部病灶，同时较好保留脉管结构，在胰头区、肝门区、肾门及前列腺等复杂解剖部位展现出独特优势。近年来研究提示，IRE还可能通过诱导免疫原性细胞死亡并重塑肿瘤微环境，增强抗肿瘤免疫应答。本文综述了不可逆电穿孔（IRE）的作用机制、技术优势、在不同复杂部位肿瘤中的疗效与安全性，以及当前挑战与未来发展方向。

Irreversible electroporation (IRE) is a non-thermal ablation modality that employs high-intensity, short-pulsed electric fields to induce irreversible cell membrane damage. It has garnered increasing attention for the treatment of tumors located in anatomically complex locations. For tumors adjacent to critical structures such as major blood vessels, bile ducts, and nerves, conventional surgery often entails substantial trauma and elevated perioperative risks, whereas thermal ablation is constrained by the risk of collateral thermal injury and the heat sink effect, which may compromise both therapeutic efficacy and patient safety. In contrast, IRE slectively eliminates local lesions through permanent membrane permeabilization while preserving the integrity of vascular and ductal structures, thereby offering distinct advantages in challenging regions including the pancreatic head, hepatic hilum, renal hilum, and prostate. Moreover, emerging evidence suggests that IRE may potentiate anti-tumor immune responses by inducing immunogenic cell death and remodeling the tumor microenvironment. This review summarizes the mechanisms of action, technical advantages, clinical efficacy and safety of IRE in tumors arising from various complex anatomical sites, and also discusses current challenges and future directions for this promising technique.