经气管镜介入治疗肿瘤所致气管狭窄疗效观察

Curative effect of bronchoscope on airway stenosis induced by tumors

目的探讨采用经支气管镜介入治疗大气道肿瘤所致气管狭窄治疗效果。方法经支气管镜冷冻、高频电切(圈套器)、氩气刀及支架置入方法,治疗20例大气道肿瘤所致气管狭窄,并与治疗前进行比较,观察治疗效果。结果 20例患者经支气管镜下冷冻、高频电刀(圈套器)、氩气刀、气管支架植入术治疗,其中完全有效11例(55%),部分有效7例(35%),轻度有效2例(10%),总有效率为100%。治疗后患者咳嗽、气短、呼吸困难得到不同程度的缓解,阻塞性肺炎及肺不张全部好转。结论经支气管镜介入治疗大气道肿瘤所致气管狭窄,可快速使肿瘤体积缩小,气管管腔重新通畅,临床症状得以改善,生活质量明显提高。经气管镜介入治疗大气道肿瘤,治疗效果显著,治疗方法比较安全。对于气管内肿瘤以冷冻、高频电刀(圈套器)和氩气刀治疗为主,部分使用气管支架。对于管腔外压性狭窄,只有使用气管支架置入。

Objective To investigate outcome of the interventional treatment of tracheal stenosis caused by tracheal tumors through the bronchoscope. Methods 20 cases with airway tumor were treated with one or two method of including cryosurgery, high frequency electroeautery, argon plasma coagulation and tracheal stent implantation through the bronehoscope. Curative effects were observed and , compared between before and after treatment. Results Among 20 eases, Full effectiveness was achieved in 11 cases （55%）, partial effectiveness was in 7 cases （35%）, mild effectiveness was in 2 cases （ 10% ）. The total effective rate was 100%. After treatment, cough, shortness of breath and dyspnea were relieved at various degrees. Obstructive pneumonia and atelectasis were all effectively relieved. Conclusion Interventional treatment of tracheal stenosis caused by airway tumors through bronehoscope can make tumor regression, reopen the tracheal lumen and relieve clinical symptoms . Patients＇ quality of life are improved. The method of interventional treatment through hroneoseope is safe and effective. Cryosurgery, high frequency eleetrocautery and argon plasma eoagalation can be mainly used for the stenosis caused by inner obstructed by airway tumor. The tracheal stent implantation can be mainly used for the stenosis by external pressure of airway tumors.