肺癌致上腔静脉梗阻介入治疗的疗效评价

Curative effect evaluation for superior vena cava obstruction caused by lung cancer

目的探讨经血管内支架置入术联合经皮肺^(125)I放射性粒子植入治疗肺癌致上腔静脉综合征(superior vena cava syndrome,SVCS)的临床疗效。方法选取2016年1月~2018年12月我院收治的31例SVCS患者临床资料,均行内支架置入术后序贯经皮肺^(125)I放射性粒子植入。结果31例患者一次性血管内支架置入成功率为100%,即刻造影均显示病变段上腔静脉(SVC)血流通畅,管径扩大;术中、术后患者无严重并发症(上腔静脉破裂、症状性肺动脉栓塞);术后症状、体征完全缓解19例,部分缓解12例,无效0例;^(125)I放射性粒子植入术后,完全缓解0例,部分缓解26例,疾病稳定5例,进展0例;^(125)I放射性粒子植入后放射性肺损伤、放射性食管炎发生率分别为32.3%、19.4%,未发生Ⅲ级及以上不良反应。结论经血管内支架置入术联合经皮肺^(125)I放射性粒子植入治疗肺癌所致SVCS临床缓解率高、见效快、安全性高。

Objective To investigate the clinical efficacy of transvascular stenting combined with transdermal lung^(125)I radioactive seed implantation in the treatment of superior vena cava syndrome caused by lung cancer.Methods Clinical data of 31 SVCS patients admitted to our hospital from January 2016 to December 2018 were selected.All patients underwent stent implantation followed by percutaneous pulmonary^(125)I radioactive seed implantation.Results The success rate of one-time stent placement was 100%,and immediate angiography showed smooth flow of upper venous blood and enlarged pipe diameter;No serious complications occurred during and after operation(superior vena cava rupture,symptomatic pulmonary embolism).Postoperative symptoms were completely relieved in 19 cases,partially relieved in 12 cases,and invalid in 0 cases;After^(125)I radioactive particles implantation,the radioactive lung injury,radioactive esophagitis rates were 32.3%,19.4%,with no adverse reactionⅢmagnitude and above.Conclusion The treatment of SVCS caused by lung cancer by stent implantation combined with percutaneous^(125)I radioactive seed implantation is characterized by high clinical remission rate,quick response and high safety.