B超对肺癌急症的诊断及疗效评估

B ultrasonographic diagnosis of emergency complications in lung cancer patients

目的评价Ｂ超对肺癌急症的快速鉴别诊断价值。方法应用Ｂ超诊断肺癌急症３５例，其中有中央型右上肺癌肿块压迫引起的上腔静脉综合征（ＳＶＣ）５例，探查取胸骨右缘第２、３肋间；中大量心包积液伴亚急性心包填塞症１０例，包括心肌与心包转移癌致急性出血性心包积液２例，探查取心前区及左腋前线第５、６肋间；恶性胸腔大量积液２０例，探查位于两侧背部膈上。介入性治疗，Ｂ超定位穿刺抽液并腔内注入中药榄香烯乳，配合临床化疗药物、输血等综合治疗。结果在４周内急症得到暂时缓解者占８２．８％，稳定占８．５％，无效占８．５％。结论简便、可重复性的超声诊断及时、可靠，并可提供疗效参考依据，证实榄香烯乳对控制急性心肌心包出血有特效，起乳剂微栓止血作用。对部分包裹性胸腔积液无效。Ｂ超对ＳＶＣ诊断有一定局限性。

Objectives To assess the value of B ultrasonography in the diagnosis and treatment of emergency complications in lung cancer patients. Methods Thirty five patients with lung cancer who suffered from emergency conditions were examined with B ultrasonography. Of the 35 cases, 5 had superior vena caval syndrome due to compression by a centrally located tumor mass in the right upper lobe; 10 had moderate to large accumulation of fluid in the pericardium with cardiac tamponade; 2 had metastasis to the myocardium and pericardium with acute hemorrhagic pericardial effusion; 20 had massive pleural effusion. The ultrasonographic features of these complications were described. Patients with pericardial or pleural effusion received intervention treatment with Elemen emulsion under B ultrasound guidance.Results Combined with systemic chemotherapy, in 4 week period, complications were temporarily ameliorated in 82.8% and became clinically stable in 8.5% of the cases. Treatment was of no effect in 8.5%.Conclusion B ultrasonography is of value in the diagnosis of emergency complications of lung cancer and is of help to guide intervention treatment.