经纤维支气管镜介入治疗肺癌的临床病例研究

The research of the case of lung cancer treated by bronchoscope interventional therapy

目的探讨经纤维支气管镜下高频电凝术、氩等离子凝固术(argon plasma coagulation,APC)方法治疗肺癌伴气道阻塞的疗效、并发症及不良反应。方法 17例经细胞学或病理确诊的肺癌患者,支气管镜下明确有气道阻塞和(或)阻塞性肺炎、肺不张,经支气管镜下行高频电凝术和(或)氩等离子凝固术,术后追踪观察气道狭窄再通程度及患者临床症状并予以评价。结果 17例患者经高频电凝术或氩等离子凝固术治疗共计24次后,临床评价完全有效1例,部分有效13例,轻度有效2例,无效1例,无严重并发症发生。结论经支气管镜下行高频电凝术、氩等离子凝固术等介入治疗方法能完全或部分消除瘤体,减轻肿瘤负荷,缓解患者症状,且创伤小、并发症及不良反应少,是临床治疗晚期肺癌伴气道阻塞的有效方法,值得进一步推广。

Objective To evaluate the effect,complications and side effects of the bronchoscopic argon plasma coagulation therapy on bronchial carcinoma complicated with airway obstruction. Methods 17 lung cancer patients diagnosed by cytology or pathology and complicated with airway obstruction or pulmonary atelectasis, High-frequency electric coagulation or Argon plasma coagulation therapy was performed through branchoscope to ease the airway obstruction by diminish the tumor. And after the operation, The location of the airway lesions, the degree of obstruction, dyspnea index, and complications were evaluated. Result The 17 patients were treated 24 times by dila- tation of saccule or Argon plasma coagulation therapy. Full effectiveness was achieved in 1 patient, partial inl3 patients, and mild in the other 2 patients and no effect in 1 patient, without serious complications happened. Conclusion Dilatation of saccule or bronchoscopic ar- gon plasma coagulation therapy can partly or remarkably reduce the tumor size, relieve clinical symptoms, and has the advantage of little damage ,fewer complications and side effects, it is a effective and safe method in clinic to treat the patient of lung cancer complicated with airway obstruction, and deserve the development.