经改良人工气道支气管镜下冷冻治疗晚期中央型肺癌的探讨

The Clinical Analysis of Freezing Therapy with Bronchoscopy Accoss the Improved Artificial Airway for Advanced Central Lung Cancer

目的探讨经改良人工气道支气管镜下冷冻治疗晚期中央型肺癌的可行性、安全性和实用性。方法回顾分析我院2011年2月～2012年12月经改良人工气道支气管镜对43例晚期中央型肺癌进行冷冻治疗的临床资料,术前和术后进行疗效评估。评价指标包括术前、术后咳嗽、咯血、发热症状,呼吸困难指数,影像学检查,支气管镜复查气道狭窄情况等。结果患者咳嗽减轻16例(84.2%),咯血缓解15例(78.9%),发热缓解12例(80.0%),术前呼吸困难指数(3.1±0.47),术后(1.6±0.43),P<0.05,影像学提示阻塞性肺炎、肺不张完全缓解消退17例(39.5%),部分缓解23例(53.5%),有效40例(93.0%),无效3例(7.0%)。结论经改良人工气道支气管镜下冷冻治疗中央型肺癌可以缓解咳嗽、咯血、发热、呼吸困难等症状,并发症少、安全性高,值得临床推广。

Objective To assess the feasibility, safety and clinical practicality value of freezing therapy with bronchoscopy accoss the improved artificial airway for advanced central lung cancer. Methods The clinical data of 43 cases of freezing therapy via bronchofibroscope for advanced central lung cancer from February 2011 to December 2012 were retrospectively analyzed. The curative effects were assessed before and after treatment. There were followingevaluation indicators including preoperative and postoperative cough, hemoptysis, fever, dyspnea index, imaging examination, review of airway stenosis bronchoscopy etc. Results The research showed patients with cough relieving were 16 cases （84. 2%）, hemoptysis remission in 15 cases （78. 9%）, fever response in 12 cases （80. 0%）, preoperative dyspnea index （ 3. 1 ± 0. 47 ）, postoperative （ 1.6 ± 0.43 ）, P〈0.05, imaging suggestive of obstructive pneumonia and atelectasis disappeared in 17 cases （ 39. 5 % ）, 23 cases （53. 5 %） improved, 40 cases effective （ 93. 0%） ,3 eases no changes （7. 0%）. Conclusion Freezing therapy with brochoscopy accoss the improved artificial airway for advanced central lung cancer is feasible, safe and practical. It has the advantages of relieving cough, hemoptysis,fever, dyspnea etc, fewer complications and high security, which should be developed extensively in clinic.