支气管镜下冷冻联合氩等离子电凝治疗恶性气道狭窄伴发呼吸困难的临床效果

The Clinical effect of bronchoscopic cryotherapy combined with argon plasma coagulation in the treatment of malignant airway stenosis with dyspnea

目的分析支气管镜下冷冻(broncho-scopic cryotherapy,B-sC)联合氩等离子电凝(argon plasma electrocoagulation,APE)治疗恶性气道狭窄(Malignant airway stenosis,MAS)伴发呼吸困难的临床效果。方法收集中国人民解放军联勤保障部队第九〇三医院2018年6月至2022年10月诊治的72例恶性气道狭窄伴发呼吸困难患者的临床资料,按照治疗方式不同分为观察组35例,对照组37例。对照组行APE治疗,观察组行B-sC联合APE治疗。比较两组患者临床疗效、气促指数、血气分析指标、肺功能和并发症。结果观察组临床总有效率(97.14%)高于对照组(72.97%)(P<0.05)。术后5 d,两组患者气促指数、PaCO_(2)水平低于术前,而SaO_(2)、FEV_(1)高于术前,且观察组患者气促指数、PaCO_(2)水平低于对照组,SaO_(2)、FEV_(1)高于对照组(P<0.05)。观察组并发症发生率(11.43%)低于对照组(32.43%)(P<0.05)。结论B-sC联合APE治疗可改善MAS伴发呼吸困难患者的血气分析水平和肺功能,缓解气促,提高临床疗效,减少并发症。

Objective To analyze the clinical effect of broncho-scopic cryotherapy(B-sC)combined with argon plasma electrocoagulation(APE)in the treatment of malignant airway stenosis(MAS)accompanied by dyspnea.Methods The clinical data of 72 patients with malignant airway stenosis and dyspnea diagnosed and treated in the hospital from June 2018 to October 2022 were collected.According to different treatment methods,they were divided into an observation group of 35 cases and a control group of 37 cases.The control group received APE treatment,while the observation group received B-sC combined with APE treatment.The clinical efficacy,shortness of breath index,Blood Gas Analysis levels,respiratory function,and complications were compared between the two groups.Results The total clinical effective rate in the observation group(97.14%)was higher than that in the control group(72.97%)(P<0.05).On the 5th day after surgery,the shortness of breath score and PaCO_(2) level of patients in the two groups were lower than those before surgery,while SaO_(2) and FEV_(1) were higher than those before surgery.Moreover,the shortness of breath score and PaCO_(2) level of patients in the observation group were lower than those in the control group,while SaO_(2) and FEV_(1) were higher than those in the control group(P<0.05).The incidence of complications in the observation group(11.43%)was lower than that in the control group(32.43%)(P<0.05).Conclusion B-sC combined with APE treatment can improve the respiratory function and blood flow of patients with dyspnea associated with MAS,reduce shortness of breath,improve clinical efficacy,and reduce complications.