肺癌支气管动脉灌注化疗引起食管支气管瘘

Esophago-Trachial Fistula Formation Caused By Bronchial Arterial Infusion Chemotherapy In Lung Cancer(Report of 3 Cases)

作者自1986～1994年间对1200例中晚期肺癌病人,径4000余人次的支气管动脉灌注(BAD 抗癌药物治疗,发生食管炎7例,占7/4000(1.75‰);食管支气管瘘3例,占3/4000(0.75‰),这三例中1例经手术修补成活,2例死亡。作者提出发生食管支气管瘘的主要原因是左、右支气管动脉均有分支供血食管,当较高浓度的5Fu,阿霉素或丝裂霉素灌注治疗后,引起食管炎、溃疡、直至穿孔,瘘管形成。并对这一并发症的诊断与鉴别诊断、治疗和预防作较详细的讨论。

1200 patients with advanced lung cancer treated with more than 4000 bronchiall arterial infusions of anticancer drugs were collected by author from 1986～1994. Among the complications of these cases esophagitis in 7(1.75%)and esophago-tracheal fis- tula in 3(0.75%).Out come of the latter,only one was survived operative repair,the oth- ers died.The author presented the main reason for esophago-tracheal fistula was due to the blood supply of esophagus from the left or right bronchial artery.The concentration high in- fusions of 5-FU,ADM,MMC could cause esophagitis,ulcer,or even perforation and fistu- la.The diagnosis,differential diagnosis,therapy and prevention of this complication were discussed in detail.