支气管镜介导下氩气刀与氩气刀联合冷冻技术治疗气道狭窄的对照研究

Prospective study of argon plasma coagulation （APC） and cryotherapy combined with APC un- der bronchoscopy for airway stenosis

目的评价支气管镜介导下使用氩气刀与联合使用氩气刀及冷冻技术治疗气道狭窄，对比其有效性和安全性。方法选择2008年7月至2010年4月门诊及住院治疗的气道狭窄患者，根据病因及气道内的镜下表现，判断具有支气管镜介导下氩气刀治疗指征的患者，随机进入氩气刀治疗组或氩气刀联合冷冻治疗组。追踪复查支气管镜，评价疗效。结果14例患者根据病情需要另外联合支架置入和／或后装放疗，其中6例属氩气刀治疗组．氩气刀联合冷冻治疗组8例。40例患者共进行127次气管镜检查治疗。两组患者疗效相比差异无统计学意义（P=0．173），均未出现并发症。结论气管镜介导下使用氩气刀与联合使用氩气刀及冷冻技术治疗气道狭窄，均能达到满意的临床疗效，安全可靠。

Objective To compare the efficacy and safety of argon plasma coagulation （APC） with cryotherapy combined with APC under flexible bronchoscopy to treat airway stenosis. Methods Patients with inoperable airway stenosis which are suitable for APC treatment are assigned to APC group or APC combined with cryotherapy group randomly. Then, evaluate the effect of the two different therapy by bronchoscopy. Results Fourteen of the total 40 patients have to undergo other therapy such as implanting stents and/or brachytherapy because of their special conditions, 6 of them belonging to APC group, 8 of them belonging to APC combined with cryotherapy group. Forty patients underwent 127 times of bronchoscopy. No differences in efficacy and safety were discovered between the two groups （P = 0. 173 ）. Conclusions APC and cryotherapy combined with APC under bronchoscopy for airway stenosis were clinically safe and effective.