气道肿瘤造成气管狭窄经支气管镜介入治疗的临床疗效研究

目的:回顾性分析探讨肿瘤致气道狭窄的患者经气管介入治疗过程中该法的应用价值,为类似病情治疗提供理论参考。方法:收集76例我院2016年3月—2018年9月收治的气道肿瘤致气道狭窄并接受支气管镜介入治疗的病例资料,分析致使恶性气道狭窄的肿瘤类型成因,并分析评价其治疗前后气道内径、气促分级、治疗效果、术中并发症等临床资料,评估支气管介入治疗方式在该类病情治疗过程中的安全性及有效性。结果:均经病理证实的76例气道狭窄病例中,肺癌71例,肾癌肺转移2例,甲状腺癌气管侵犯3例。经支气管镜介入治疗气道狭窄,治疗前平均气道内径由0.57±0.18mm增至治疗后1.19±0.14mm,平均气道内径增加明显(P<0.05);平均气促分级由3.22±0.48降至治疗后1.52±0.79,气促分级降低明显(P<0.05);治疗总有效率达100%;患者术前平均KPS评分60.42±4.92,术后增至79.31±8.03,差异有统计意义(P<0.05);支气管镜介入治疗术中并发症多为出血、心律失常、一过性血氧低等,术中均得到有效控制。结论:肺癌中腺癌是导致气道狭窄的高发原因;支气管镜介导的手术治疗能直接可解除气道狭窄问题同时辅助其他放化疗,增强治疗效果。

Clinical effect of bronchoscopic interventional treatment of tracheal stenosis caused by airway tumor

Objective To retrospectively analyze the application value of this method in patients with tumor-induced airway stenosis during tracheal intervention,and to provide a theoretical reference for similar disease treatment.Methods 76 cases of airway stenosis caused by airway tumors treated in our hospital from March 2016 to September 2018 and receiving bronchoscopic interventional therapy were collected.The causes of the types of tumors that caused malignant airway stenosis were analyzed,and their treatment was analyzed and evaluated.The clinical data such as effects,intraoperative complications,etc.were used to evaluate the safety and effectiveness of bronchial interventional therapy in the treatment of this type of condition.Results The 76 cases of airway stenosis confirmed by pathology,71 were lung cancer,2 were lung metastasis of renal cancer,and 3 were tracheal invasion of thyroid cancer.Transbronchial intervention for airway stenosis with a total effective rate of 100%;the average KPS score of patients before surgery was 60.42±4.92,which increased to 79.31±8.03 after surgery,the difference was statistically significant(P<0.05);during bronchoscopic interventional surgery The complications were mostly bleeding,arrhythmia,transient hypoxemia,etc.,which were effectively controlled during the operation.Conclusion Adenocarcinoma in lung cancer is a high cause of airway stenosis;bronchoscopy-mediated surgery can directly relieve airway stenosis and assist other chemoradiotherapy to enhance the treatment effect.