氩气刀结合放射性^(125)Ⅰ植入对比放疗诊疗肺癌气道狭窄的疗效研究

Comparative study of argon knife combined with radioactive ^(125)Ⅰ implantation and external radiotherapy in the treatment of airway stenosis of lung cancer

目的:比较支气管镜引导下氩气刀结合放射性^(125)Ⅰ 植入与支气管镜引导下氩气刀结合放疗治疗肺癌患者气道狭窄的临床疗效及并发症。方法:选择50例2015年1月至2021年8月我院区收治的肺癌气道狭窄患者,随机分成试验组和对照组各 25 例,前者采取支气管镜引导下氩气刀结合放射性^(125)Ⅰ植入,后者应用支气管镜引导下氩气刀结合放疗,观察两组患者 1个月、3个月、6个月生存率,1个月时肿瘤体积缩小比例、再次呼吸困难发作间隔时间等疗效及术后不良反应发生情况。结果:试验组患者 1 个月、3 个月、6 个月生存率依次为 25 例(100%)、23 例(92%)、18例(72%),对照组患者依次为 24例(96%)、17例(68%)、11例(44%);两组患者 1个月生存率差异无统计学意义(P>0.05),3 个月、6 个月生存率比较,差异有统计学意义(P<0.05)。试验组患者再次呼吸困难发作时间间隔 50 天以上 17 例、1 个月时肿瘤体积缩小 10% 以上 6 例,对照组患者再次呼吸困难发作时间间隔 50 天以上 10例、1个月时肿瘤体积缩小 10% 以上 1例,两组比较差异有统计学意义(P<0.05)。结论:氩气刀结合放射性^(125)Ⅰ植入诊疗肺癌气道狭窄疗效优于氩气刀结合放疗治疗,可有效改善患者临床症状并减少并发症。

Objective:To compare the clinical efficacy and complications of bronchoscope-guided argon plasma coagulation plus radioactive^(125)Ⅰ seed implantation with bronchoscope-guided argon plasma plus radiotherapy in the treatment of lung cancer patients with airway stenosis.Methods:Fifty patients with lung cancer airway stenosis treated in our hospital from January 2015 to August 2021 were randomly divided into treatment group and control group,with 25 cases in each group.The former was implanted with argon knife combined with radioactive iodine particle ^(125)Ⅰ under the guidance of broncho‐scope,and the latter was implanted with argon knife combined with radiotherapy under the guidance of electronic bronchoscope.The 1-month,3-month and 6-month survival rates,the proportion of tumor volume reduction at 1month and the interval between the onset of dyspnea again and the occurrence of postoperative adverse reactions were observed.Results:The 1-month,3-month and 6-month survival rates of patients in the diagnosis and treatment group were as follows 25(100%),23(92%),18(72%),the patients in the control group were 24(96%),17(68%)and 11(44%),there was no significant difference in 1-month survival rate between the two groups(P>0.05),but there was significant difference in 3-month and 6-month survival rate(P<0.05).The interval between the onset of recurrent dyspnea in the treatment group at an interval of more than 50 days were 17 cases,At 1 month,the tumor volume decreased by more than 10% in 6 patients.The interval between the onset of recurrent dyspnea in the control group at an interval of more than 50 days were 10 cases.At 1 month,the tumor volume decreased by more than 10% in 1 patient in the control group.There were significant differences between the two groups(P<0.05).Conclusion:Argon plasma coagulation plus^(125)I seed implantation is superior to argon plasma coagulation plus radiotherapy in the treatment of lung cancer airway stenosis.It can effectively improve patients’ clinical symptoms and reduce complications.