冷冻消融治疗晚期肺肿瘤的临床价值探讨

Clinical Significance for cryo-ablation Treating Advanced Pulmonary Neoplasm

目的探讨氩氦刀对晚期肺癌治疗的价值.方法 40例肺肿瘤,其中肺癌33例,转移癌7例.肺癌中Ⅰ期3例,Ⅱ期2例,Ⅲa期5例,Ⅲb期11例,Ⅳ期12例.肺原发癌或转移癌氩氦刀冷冻治疗共43例次.伴恶性胸腔积液者,配合应用胸腔促粘连剂、辅助化疗;颅内转移灶放疗.治疗后用CT、胸片和生活质量评分方法( Karnofsky评分)评价疗效.结果 40例中有31例生存,9例死亡.31例有36个氩氦刀治疗灶分别缩小15%～90%;绝大多数患者胸液消失或仅有少量;食欲改善,体力、体重增加;胸闷、胸痛、咳嗽、气喘症状减轻或消失.中位生存期6个月.Karnofsky评分提高了10～30分.结论氩氦刀在综合治疗肺肿瘤中,对控制局部肿瘤、改善全身状况具有独特的、重要价值.

Objective To probe into significance of cryo care system (CCS) for advanced pulmonary neoplasms. Methods There were 33 patients with lung cancer, 7 with pulmonary metastasis tumor in the 40 patients; total 43 lesions were treated by CCS. There were stage Ⅰ 3 cases, stage Ⅱ 2, stage Ⅲa 5, stage Ⅲb 11, stage Ⅳ 12 in the patients with lung cancer. If the patients complicated malignant hydrothorax, the stimulant was injected into thorax for pleurodesis.and assisted chemotherapy; intracranial metastatic tumors by radiotherapy. The curative effects estimated by chest CT scan, X ray chest film and Karnofsky score. Results There were 31 patients survival; died 9 in 40 cases. 36 lesions in 31 patients treated by CCS shrank 15%～90% respectively. Malignant pleural effusion in the most of those patients disappeared or stopped increase and only a little .The patients had good appetite, got force and weight. Chest distress ,chest pain, cough, breathlessness symptoms were alleviation or disappearance . Media survival 6M. Karnofsky score raised from 10 to 30. Conclusion CCS in the comprehensive therapy pulmonary neoplasm was possessed of a special, important valuable for the controlling local malignances, improving general condition.