气管镜下热消融联合冷冻切除术治疗气道良性肿瘤的临床分析

Bronchoscopic treatment with combined heating techniques and crytherapy for benign endobronchial tumors

目的：总结分析气管镜下热消融联合冷冻切除术治疗原发气管、支气管良性肿瘤的应用价值.方法：总结北京友谊医院呼吸内科2010年至2012年间,6例原发气管/支气管良性肿瘤患者的临床表现、胸部CT、支气管镜下表现、病理类型及内镜下介入治疗方法及转归.结果：6例患者均为男性,病程在1个月～10年;病理类型包括：错构瘤3例,脂肪瘤1例、鳞状上皮乳头状瘤1例,肉芽肿1例.全部患者均在局麻联合静脉麻醉下进行气管镜下介入治疗手术,均采取热消融联合冷冻技术.所有病例术后气道完全开通,解除了气道梗阻.其中4例一次性手术清除病灶;1例因病灶分布广,分2次手术;1例因气道狭窄明显且狭窄部位位于声门下,分3次手术.术后无严重并发症,随访无复发.结论：气管镜下热消融联合冷冻治疗原发气管、支气管良性肿瘤疗效确切,简单、创伤小并安全.

Objective：To evaluate the therapeutic utility of combined heating techniques and cryotherapy to treat benign endobronchial tumors.Methods：We reviewed the clinical manifestation,CT features,bronchoscopic appearance and pathologic types of 6 patients with benign bronchial tumors,and the efficacy of combined electrocautry,argon plasma cogulation and cryotherapy for the treatment of the 6 patients.Results：Six male patients with different types of tumor were included （hamartoma,3 cases ; lipoma 1 case ; papillary epithelioma,1 case; granuloma,1 case）.The course of disease was between 1 month and 10 years.For all cases,we employed local and intravenous anesthesia before inserting flexible bronchoscope.By using combined electrocautry,argon plasma cogulation and cryotherapy,we removed tumors and made all patients＇ respiratory tracts unobstructed.Of these cases,4 cases were treated one times,1 case two times because of extensive lesion,and 1 case three times because of severe obstructed airway right below the glottis.No severe complications or recurrences were occurred.Conclusion：Combined electrocautry,argon plasma cogulation and cryotherapy for benign bronchial tumor are effective,simple,less invasive and safe.