摘要
目的为实现介入治疗后即刻缓解恶性肿瘤导致的中央气道阻塞,观察纤维支气管镜下冷冻联合氩等离子体凝固这种治疗模式的疗效及其安全性。方法共观察75例中央气道阻塞患者,在支气管软镜下治疗,应用K300型冷冻治疗机及ERBE300型氩等离子体凝固治疗仪。手术分3步,分别为冷冻、氩等离子体凝固、冻切。对于较大的病变可重复进行,治疗结束后3d评价疗效。评价指标包括术前术后呼吸困难指数、生活质量评分、支气管镜检查等,手术安全性评估主要观察术中出血情况。结果呼吸困难评分术后较术前至少提高一级的有47例(62.7%),28例(37.3%)自觉呼吸困难无明显改善。生活质量评分术前(60.0±8.7)分,术后(75.0±9.2)分。支气管镜复查:完全有效22例(29.3%),部分有效44例(58.7%),无效9例(12%)。总体临床有效率88.0%。手术中出血控制满意,无重度出血发生,中度出血12例(16.0%),轻度出血63例(84.0%)。术中无需使用硬质气管镜。结论在支气管软镜下采用冷冻联合氩等离子体凝固可即刻缓解中央气道阻塞,疗效满意,手术安全性较高。
【Objective】To evaluate the immediate effects and safety of the new mode of cryosurgery combined with argon plasma coagulation used for central airway obstruction via a flexible bronchoscope. 【Methods】There were 75 patients who suffered from central airway obstructive were observed. The new therapy mode includes 3 steps: cryosurgery, argon plasma coagulation and cryorecanalization. These three steps can be repeated if the tumor was too big. The efficacy evaluation was performed at the time of three days after the surgery. The score of dyspnea and Karnofsky were recorded and bronchoscopy was performed. The surgical safety assessment was mainly used for observing the bleeding condition in the surgery. 【Results】Dyspnea score improved by at least one class in 47 (62.7%) patients and remained unchanged in 28(37.3%) patients. The Karnofsky score of preoperative was (60±8.7) and the postoperative was (75±9.2). The quantity of complete success patients were 22(29.3%), partial success were 44 (58.7%), and no success were 9 (12%) by bronchoscopy. Severe bleeding did not occur. moderate bleeding oc- curred in 12(16.0%) patients and mild bleeding in 63(84.0%) patients.【Conclusion】The new mode of cryosurgery combined with argon plasma coagulation can immediately relieve central airway obstruction and is safe too.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第11期1170-1173,共4页
China Journal of Endoscopy
关键词
氩等离子体凝固
冷冻手术
支气管镜
中央气道阻塞
argon plasma coagulation
cryosurgery
bronchoscope
central airway obstruction
