气管镜治疗恶性肿瘤所致阻塞性肺不张的临床研究

Clinical study on bronchoscopy in the treatment of obstructive atelectasis caused by malignant tumors

目的探讨气管镜治疗恶性肿瘤所致阻塞性肺不张的安全性和有效性,以期提高临床诊治水平。方法回顾性分析2011年2月-2012年12月65例经过病理证实的恶性肿瘤所致阻塞性肺不张患者,均在气管镜下行氩等离子体凝固、冷冻方法治疗,观察各个肺段在的疗效和气促评分在治疗前后的差异性。结果在呼吸道肿瘤清除情况上,CR例数为27例,比率为41.54%,PR例数为30例,比率为46.15%,NR例数为8例,比率为12.31%;在肺复张上,CR例数为42例,比率为64.62%,PR例数为19例,比率为29.23%,NR例数为4例,比率为6.15%;治疗前后在体质评分、气促评分和KPS自由评分以及症状改善情况上比较有明显的差异性(P<0.05),有统计学意义。结论气管镜能使气道内的恶性肿瘤快速、有效清除,对所致阻塞性肺不张能有效的复张。

Objective To investigate the effect of bronchoscopy in the treatment of obstructive atelectasis caused by malignant tumors. Methods 65 patients with obstructive atelectasis caused by malignant tumors were all given coagulation and freezing under bronchoscope. Their curative effect and score of breath shortness were observed in each lung segment. Results In the upper respiratory tract tumor removals, there were 27 cases of CR （41.54%）, 30 cases of PR （46. 15% ）, and 8 cases of NR （12. 31% ）. In lung recruitment, there were 42 cases of CR （64. 62% ）, 19 cases of PR （29. 23% ）, and 4 cases of NR （6. 15% ）. Conclusion Bronchoscopy enables the clear of malignant tumors quick and effective in the treatment of obstructive atelectasis caused by malignant tumors.