经纤维支气管镜腔内高频电刀治疗中央气道肿瘤的临床研究

Clinical study of high-frequency electric knife through fiberoptic bronchoscopy in the treatment of central airway tumor

目的观察中央气道肿瘤予以纤维支气管镜腔内高频电刀治疗的临床价值。方法 30例中央气道肿瘤患者,均经纤维支气管镜高频电刀治疗,观察分析患者治疗前后气促指数、气道内径、动脉血氧分压(PaO_2)和动脉血二氧化碳分压(PaCO_2)的改善情况。结果患者治疗前的气促指数为(3.1±0.7)级,治疗后气促指数为(1.5±0.8)级,治疗后气促指数明显低于治疗前,差异有统计学意义(P<0.05);治疗前气道内径为(1.00±0.02)mm,治疗后气道内径为(8.50±0.80)mm,治疗后气道内径明显大于治疗前,差异有统计学意义(P<0.05);治疗前PaO_2为(9.5±1.4)k Pa,治疗后PaO_2为(11.4±1.2)k Pa,治疗后PaO_2数值明显高于治疗前,差异有统计学意义(P<0.05);治疗前PaCO_2为(9.6±3.5)k Pa,治疗后PaCO_2为(3.9±1.2)k Pa,治疗后的PaCO_2数值较治疗前明显降低,差异有统计学意义(P<0.05)。治疗过程中除10例出现一过性低氧血症及1例少量出血外,未见其他严重并发症。结论中央气道肿瘤患者予以纤维支气管镜介导的高频电切治疗,效果理想,患者的症状可以有效改善,生活质量也会有所提升,可在临床上进一步普及。

Objective To observe the clinical value of high-frequency electric knife through fiberopticbronchoscopy in the treatment of central airway tumor.Methods A total of30patients with central airway tumorswere treated with high-frequency electric knife through fiberoptic bronchoscopy.Observation and analysis weremade on improvement of dyspnea index,airway diameter,arterial partial pressure of oxygen(PaO2)and arterialpartial pressure of carbon dioxide(PaCO2)of the patients before and after treatment.Results Patients haddyspnea index as(3.1±0.7)grades before treatment and(1.5±0.8)grades after treatment.Patients had lowerdyspnea index after treatment than before treatment,and the difference had statistical significance(P<0.05).Patients had airway diameter as(1.00±0.02)mm before treatment and(8.50±0.80)mm after treatment.Patientshad larger airway diameter after treatment than before treatment,and the difference had statistical significance(P<0.05).Patients had PaO2as(9.5±1.4)kPa before treatment and(11.4±1.2)kPa after treatment.Patientshad obviously higher PaO2after treatment than before treatment,and the difference had statistical significance(P<0.05).Patients had PaCO2as(9.6±3.5)kPa before treatment and(3.9±1.2)kPa after treatment.Patients hadobviously lower PaCO2after treatment than before treatment,and the difference had statistical significance(P<0.05).Except for10cases of transient hypoxemia and1case of small amount of bleeding,there were no other seriouscomplications.Conclusion High-frequency electric knife by fiberoptic bronchoscopy shows ideal effect in thetreatment of central airway tumor patients,and it can effectively improve symptoms and quality of life in patients.So it can be further promoted in clinic.