气管、支气管肿瘤的冷冻外科治疗

The cryosurgery of tracheo-bronchial tumors

目的 :探索和推广一种新的治疗中晚期气管、支气管肿瘤的微创手术方法。方法 :在全麻和硬质支气管镜辅助下 ,对 2 8例中晚期气管、支气管肿瘤的非手术患者进行了气管内冷冻外科治疗。其中中心型肺癌 2 6例、支气管类癌 1例、支气管内肉芽组织增生 1例。对照观察术前、术后自觉症状及肺功能情况。结果 :自觉症状明显改善 ,改善率 :咳嗽为 6 4 .3%、呼吸困难 71.4 %、咯血 93.7%、胸痛 6 2 .5 %。肺功能也明显改善 :平均 1秒钟用力呼气量从 1.2 3L提高到 1.5 6L(P <0 .0 1) ,平均用力肺活量从 1.89L提高到 2 .12L(P <0 .0 5 )。无严重并发症和手术死亡。结论 :气管、支气管冷冻外科治疗可以迅速控制和缓解不能手术患者的自觉症状、改善肺功能 ,是一种简便、有效的微创手术方法。

Objective:To study and improve a new mini invasive treatment of advanced stage tracheo bronchial tumors.Methods:28 advanced stage tracheo bronchial tumor patients have been treated by cryosurgery under general anaesthesia and rigid bronchoscopy.Symptoms and respiratory function have been observed.Results:Subjective symptomatic improvement for cough was 64.3%, dyspnea 71.4%, hemoptysis 93.7% and chest pain 62.5%. Respiratory function tests showed improvements in mean FEV 1.0 from 1.23 L to 1.56 L( P <0.01) and mean FVC from 1.89 L to 2.12 L( P <0.05).There was no complications and operative mortality.Conclusion:Cryosurgery provides effective and rapid control of symptoms caused by tracheo bronchial tumors and improves quality of life and survival.It is easy to perform with minimum complications.