经电子支气管镜氩等离子体凝固联合高频电及冷冻治疗气道狭窄31例临床观察

目的观察经电子支气管镜氩等离子体凝固联合高频电及冷冻治疗良恶性气道狭窄的临床疗效及并发症。方法选择2015年3月~2017年3月在我科住院的气管、支气管良恶性狭窄患者31例,其中良性气道狭窄4例,恶性气道狭窄27例,均采用经电子支气管镜氩等离子体凝固联合高频电及冷冻治疗,术后进行气道狭窄再通评估及气促分级,与术前进行比较。结果 4例良性气道狭窄患者完全治愈,良性气道狭窄治疗有效率为100%。27例恶性气道狭窄患者中:完全有效7例(25.9%),部分有效17例(63%),轻度有效2例(7.4%),无效1例(3.7%),恶性气道狭窄治疗有效率为96.3%。31例良恶性气道狭窄治疗后总有效率为96.8%,治疗后30例患者气促分级得到改善。结论经电子支气管镜氩等离子体凝固联合高频电及冷冻治疗良恶性气道狭窄,可有效清除病变,恢复气道通畅,从而缓解患者的临床症状,改善患者的生活质量。另外还有创伤较小、并发症轻、适应证广的优点,对不能外科手术治疗或者不愿意接受外科手术治疗的气道狭窄患者提供了一种新的相对安全、有效的选择。

Clinical observation on 31 cases of argon plasma coagulation by electronic bronchoscope combined with high-frequency electricity and cryotherapy in the treatment of airway stenosis

Objective To observe the clinical efficacy and complications of argon plasma coagulation by electronic bronchoscope combined with high-frequency electricity and cryotherapy in the treatment of benign and malignant airway stenosis.Methods 31 patients with benign and malignant tracheal and bronchial stenosis who were hospitalized in our department from March 2015 to March 2017 were enrolled,including 4 patients with benign airway stenosis and 27 patients with malignant airway stenosis.The patients were treated with plasma coagulation by electronic bronchoscope combined with high-frequency electricity and cryotherapy,and underwent postoperative assessment of airway stenosis recanalization and classification of shortness of breath,and the results were compared with those before operation.Results 4 patients with benign airway stenosis were completely cured,and the effective rate of benign airway stenosis was 100%.Of the 27 patients with malignant airway stenosis,7 patients were completely effective(25.9%),17 patients were partially effective(63%),2 patients were mildly effective(7.4%)and 1 patient was ineffective(3.7%).The malignant airway stenosis treatment efficiency was 96.3%.The total effective rate of the 31 patients with benign and malignant airway stenosis was 96.8%.After the treatment,30 patients had improvement in their shortness of breath degree.Conclusion The argon plasma coagulation via electronic bronchoscope combined with high-frequency electricity and cryotherapy for benign and malignant airway stenosis can effectively remove the lesion and restore airway patency,thereby alleviating the clinical symptoms and improving the quality of life of patients,with the advantages of less trauma,light complications and broad indications.It provides a new relatively safe and effective option for patients with airway stenosis who cannot be treated surgically or who are unwilling to accept surgical treatment.