肺动脉内漂浮导管留置介入治疗肺癌36例分析

Analysis of interventional therapy in lung cancer's patients retaining pipe of afloat in the pulmonary artery for long term

目的:探讨经肺动脉内漂浮导管长期留置介入治疗肺癌的可行性及疗效.方法:采用ARROW国际公司生产的热稀释漂浮导管,经锁骨下静脉、上腔静脉、右心房、右心室进入肺动脉,定位到患肿瘤肺叶相应的肺动脉分支,皮肤缝合固定,留置导管;化疗药物根据肿瘤病理类型选用,经化疗管注入,28d为1个治疗周期,每周期1～8d按计划给药,休息20d进行第2个周期的化疗,4周期为1个疗程.结果:漂浮导管留置时间最短15d,最长91d,平均41d.导管不能继续留置的原因,以化疗管腔堵塞不能使用多见(20/36例).其次为患者生活不便,自动要求拔出(12/36例).介入治疗疗效与留置时间及化疗周期数关系密切,呈正相关.结论:长期肺动脉内导管留置介入治疗肺癌疗效肯定,但在器材的选择及留置方法上应进一步提高.

Objective： To explore the possibility and clinical value in interventional therapy of lung cancer through retaining the pipe of afloat in pulmonary artery over a long term. Methods： The pipe of afloat passed through subclavian vein, superior vena cava, right atrium, right ventricle into the pulmonary artery, fixing to the branch of pulmonary artery. The choice of chemotherapeutic medicine was according to the pathologic type of tumors and which was injected in pulmonary artery through chemotherapeutic pipeline. One treatment course was 28 days. Results： The pipe of afloat was retained for 15 days to 91 days; the average time was 41 days. The primary reason why the pipe can＇t continue to retain was the obstruction of pipe of afloat （20/36 cases）. Other reason include that patients were inconvenient in daily life and requested to pull out the pipe etc. Conclusions： The long term retaining pipe of afloat in pulmonary artery is active in interventional therapy for lung cancer, but the choice of equipment and method of retaining should be improved.