氩等离子体凝固术结合冷冻治疗恶性中央气道阻塞

Combination of argon plasma coagulation and cryotherapy for malignant central airway obstruction

目的:探讨经支气管镜氩等离子体凝固(Argon plasma coagulation,APC)结合冷冻治疗恶性中央气道阻塞(Central airway obstruction,CAO)的疗效及安全性。方法:经支气管镜对42例恶性中央气道阻塞患者进行APC结合冷冻治疗,其中非小细胞肺癌(Non-small cell lung cancer,NSCLC)39例,小细胞肺癌(Smallcelllungcancer,SCLC)3例,从症状改善情况、肺功能、气促评分、体力状况变化、狭窄再通疗效等方面进行评价。结果:42例病人经108次治疗后完全有效24例(57.14%)、部分有效15例(35.7%)、轻度有效2例(4.76%)、无效1例(2.38%)。仅有少数病例出现一过性低氧血症(20.37%)。结论:经支气管镜应用APC结合冷冻治疗恶性中央气道阻塞安全、有效。

Objective： To evaluate the effectiveness and safety of using argon plasma coagulation （APC） combined with cryotherapy via bronchoscopy for malignant central airway obstruction （CAO）. Methods： A total of 42 patients with malignant CAO, including 36 cases of NSCLC, and 6 cases of SCLC were selected and treated with APC combined with cryotherapy via bronchoscopy.The evaluation included the changes of the symptoms, pulmonary function, dyspnea index, the KPS scores and the degree of airway obstruction. Results： Full effec- tiveness was achieved in 24 cases（57.14% ）,partial effectiveness in 15 cases（35.7% ）,mild effectiveness in 2 cases（4.76% ）and 1 case （2.38%） was with no effectiveness. Only a few cases had hypoxemia transiently（20.37% ）. Conclusion： APC combined with cryotherapy via bronchoscopy is effective and safe for malignant CAO.