消化道恶性肿瘤肺转移患者纤支镜消融与保守化疗的存活期及生活质量随访

Survival time and quality of life follow-up of fiberoptic bronchoscopy ablation and conservative chemotherapy for treating patients with lung metastasis of malignant tumor of digestive tract

目的探讨经纤支镜射频消融与保守化疗对消化道恶性肿瘤肺转移患者存活期及生活质量的影响。方法选取90例消化道恶性肿瘤肺转移患者为研究对象,随机分成两组,各45例。对照组予以保守化疗方案,研究组则予以纤支镜下射频消融方案。比较两组3年存活率、临床疗效及不良反应发生情况,分析治疗前后Karnofsky功能状态评分(KPS评分)、体力状况(performance status,PS)评分及症状评分差异。结果 1研究组治疗总有效率为66.7%,显著高于对照组的44.4%(P<0.05);2治疗后,两组KPS评分均较治疗前显著提升,PS评分则较治疗前显著降低(P<0.05);其中研究组各指标改善幅度均大于对照组(P<0.05);3治疗后,两组患者乏力、咳嗽、气短、咯血、胸闷、胸痛等症状积分均较治疗前显著降低,其中研究组降幅大于对照组(P<0.05);4研究组3年存活率为53.3%,显著高于对照组的31.1%(P<0.05);研究组不良反应发生率均显著低于对照组(P<0.05)。结论纤支镜消融疗法利于消化道恶性肿瘤肺转移患者提高3年生存率、改善存活质量,治疗安全性理想。

Objective To compare the survival time and quality of life of patients with lung metastasis of malignant tumor of digestive tract treated by ablation via fiberoptic bronchoscopy and conservative chemotherapy.Methods Ninety patients with pulmonary metastasis of malignant digestive tumors were selected as the study object.According to the random number table method,they were divided equally into the study group and the control group.The control group was only treated with conservative chemotherapy,while the study group was treated with frequency ablation via fiberoptic bronchoscopy.The 3-year survival rate,clinical curative effects and incidence of adverse reactions were compared between the two groups.The differences of Karnofsky performance status scores（KPS）,performance status（PS） scores,and symptom scores before and after treatment was analyzed.Results 1 The total effective rate in the study group（66.7%） was significantly higher than that in the control group（44.4%）（P〈0.05）; 2 After the treatment,KPS scores of both two groups were significantly increased,while PS scores were significantly decreased（P〈0.05）; The improvement of indexes in the study group were greater than that in the control group（P〈0.05）;3 After treatment,the symptom scores were significantly lower than those before treatment,including fatigue,cough,shortness of breath,hemoptysis,chest distress and chest pain,etc.The decline of study group was greater than that of the control group（P〈0.05）; 4 The 3-year survival rate in the study group（53.3%） was significantly higher than that in the control group（31.1%）（P〈0.05）; The incidence of adverse reactions in the study group was significantly lower than that in the control group（P〈0.05）.Conclusion Ablation therapy via fiberoptic bronchoscopy was effective and safe for patients with pulmonary metastasis of malignant digestive tumors in improvement of 3-year survival time and the quality of life.