APC在治疗恶性气道阻塞性病变的疗效观察
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摘要
目的评估经支气管镜氩等离子体凝固术(APC)治疗气道阻塞性病变的疗效。方法分析我院经支气管镜氩等离子体凝固治疗联合化疗的肺癌患者30例(A组:APC治疗联合化疗组)和单纯化疗的肺癌患者32例(B组:单纯化疗组)。收集患者治疗前后临床症状改善情况、肺功能、血气分析、气促等级以及生活质量评分等资料。结果 A组患者经治疗后,气道再通有效率为80%,患者临床症状显著改善; B组患者经治疗后,气道再通有效率仅为18. 8%。A组患者经治疗后肺功能、气促等级和生活质量评分改善显著高于B组(P <0. 05),且患者未出现严重并发症。结论 APC治疗恶性气道阻塞性病变的近期疗效较好,可很快缓解症状,改善患者生活质量。
Objective To evaluate the efficacy of transbronchial argon plasma coagulation( APC) in treatment of airway obstructive lesions. Methods The analysis of 30 patients with lung cancer treated with APC combined with chemotherapy( the group A: APC combined with chemotherapy) and 32 patients with lung cancer treated with chemotherapy alone( the group B: chemotherapy) was performed. Their clinical data such as improvement of clinical symptoms,lung function,blood gas analysis,shortness of breath,and quality of life scores were collected before and after treatment. Results After treatment,the effective rate of airway recanalization was 80% in the group A,and the clinical symptoms of patients were significantly improved. However,the effective rate of airway recanalization in the group B was only 18. 8%. And the improvement of pulmonary function,dyspnea grade and quality of life in the group A was significantly higher than that in the group B( P < 0. 05),and there was no serious complications.Conclusion The short-term effect of APC in treatment of malignant airway obstructive lesions is perfect,which can quickly relieve symptoms and improve patients' quality of life.
Objective To evaluate the efficacy of transbronchial argon plasma coagulation( APC) in treatment of airway obstructive lesions. Methods The analysis of 30 patients with lung cancer treated with APC combined with chemotherapy( the group A: APC combined with chemotherapy) and 32 patients with lung cancer treated with chemotherapy alone( the group B: chemotherapy) was performed. Their clinical data such as improvement of clinical symptoms,lung function,blood gas analysis,shortness of breath,and quality of life scores were collected before and after treatment. Results After treatment,the effective rate of airway recanalization was 80% in the group A,and the clinical symptoms of patients were significantly improved. However,the effective rate of airway recanalization in the group B was only 18. 8%. And the improvement of pulmonary function,dyspnea grade and quality of life in the group A was significantly higher than that in the group B( P < 0. 05),and there was no serious complications.Conclusion The short-term effect of APC in treatment of malignant airway obstructive lesions is perfect,which can quickly relieve symptoms and improve patients' quality of life.
引文
[1]高亭,何小鹏,蒋引娣,等.氩等离子体凝固联合冷冻治疗恶性气道梗阻的临床分析[J].国际呼吸杂志,2016,36(8):572-575.
[2] MAHMOOD K,WAHIDI M M. Ablative therapies for central airway obstruction[J]. Semin Respir Crit Care Med,2014,35(6):681-692.
[3] MITCHELL P D,KENNEDY M P. Bronchoscopic management of malignant airway obstruction[J]. Adv Ther,2014,31(5):512-538.
[4] LEE B R,OH I J,LEE H S,et al. Usefulness of rigid bronchoscopic intervention using argon plasma coagulation for central airway tumors[J]. Clin Exp Otorhinolaryngol,2015,8(4):396-401.
[5]桂坤,朱辉,张先明,等.经支气管镜氩等离子体凝固联合冷冻技术治疗中央型肺癌伴大气道阻塞[J].现代医学,2017,45(6):794-799.
[6] STULBARG M S,ADAMS L. Textbook of respiratory medicine[M]. Philadelphia:Saunders,1994:512.
[7]王小丽,赵丽敏.分析良性中央气道狭窄的病因并比较APC与联合冷冻治疗疗效[J].医药论坛杂志,2017,38(1):20-22,26.
[8]李亚强,李强,白冲,等.良性中央气道狭窄386例病因分析及腔内介入治疗的疗效评价[J].中华结核和呼吸杂志,2008,31(5):364-368.
[9]柯昌林,刘吉华,李瑶,等.支气管镜介导氩等离子体凝固术在气道腔内病变中的应用[J].实用临床医学,2012,13(7):13-15,封4.
[10]张耀亭,吴妙芬.经纤维支气管镜高频电刀治疗气道阻塞性病变[J].中国内镜杂志,2005,11(10):1068-1070.
[11]张丽琴,王小伟,赵毅超.支气管镜介导下冷冻联合氩等离子电凝技术治疗气道狭窄[J].当代医学,2014,20(23):108-109.
[12]马长秀,陆友金,赵卉,等.氩等离子体凝固治疗气道阻塞性病变的临床观察[J].临床肺科杂志,2011,16(12):1879-1880.
[13]吴红,邵剑骏.经支气管镜氩等离子体凝固术联合冷冻治疗肺癌致气道内狭窄效果观察[J].中国乡村医药,2017,24(10):27-28.
[14]戴钰,田庆,杨震,等.经电子支气管镜氩等离子体凝固术治疗大气道阻塞72例临床分析[J].解放军医学院学报,2015,36(7):679-682.
[15]王洪武,周云芝,马洪明,等.氩等离子体凝固与氩氦刀联合治疗伴有大气道阻塞的中央型肺癌[J].中华结核和呼吸杂志,2009,32(2):152-153.
[2] MAHMOOD K,WAHIDI M M. Ablative therapies for central airway obstruction[J]. Semin Respir Crit Care Med,2014,35(6):681-692.
[3] MITCHELL P D,KENNEDY M P. Bronchoscopic management of malignant airway obstruction[J]. Adv Ther,2014,31(5):512-538.
[4] LEE B R,OH I J,LEE H S,et al. Usefulness of rigid bronchoscopic intervention using argon plasma coagulation for central airway tumors[J]. Clin Exp Otorhinolaryngol,2015,8(4):396-401.
[5]桂坤,朱辉,张先明,等.经支气管镜氩等离子体凝固联合冷冻技术治疗中央型肺癌伴大气道阻塞[J].现代医学,2017,45(6):794-799.
[6] STULBARG M S,ADAMS L. Textbook of respiratory medicine[M]. Philadelphia:Saunders,1994:512.
[7]王小丽,赵丽敏.分析良性中央气道狭窄的病因并比较APC与联合冷冻治疗疗效[J].医药论坛杂志,2017,38(1):20-22,26.
[8]李亚强,李强,白冲,等.良性中央气道狭窄386例病因分析及腔内介入治疗的疗效评价[J].中华结核和呼吸杂志,2008,31(5):364-368.
[9]柯昌林,刘吉华,李瑶,等.支气管镜介导氩等离子体凝固术在气道腔内病变中的应用[J].实用临床医学,2012,13(7):13-15,封4.
[10]张耀亭,吴妙芬.经纤维支气管镜高频电刀治疗气道阻塞性病变[J].中国内镜杂志,2005,11(10):1068-1070.
[11]张丽琴,王小伟,赵毅超.支气管镜介导下冷冻联合氩等离子电凝技术治疗气道狭窄[J].当代医学,2014,20(23):108-109.
[12]马长秀,陆友金,赵卉,等.氩等离子体凝固治疗气道阻塞性病变的临床观察[J].临床肺科杂志,2011,16(12):1879-1880.
[13]吴红,邵剑骏.经支气管镜氩等离子体凝固术联合冷冻治疗肺癌致气道内狭窄效果观察[J].中国乡村医药,2017,24(10):27-28.
[14]戴钰,田庆,杨震,等.经电子支气管镜氩等离子体凝固术治疗大气道阻塞72例临床分析[J].解放军医学院学报,2015,36(7):679-682.
[15]王洪武,周云芝,马洪明,等.氩等离子体凝固与氩氦刀联合治疗伴有大气道阻塞的中央型肺癌[J].中华结核和呼吸杂志,2009,32(2):152-153.