经人工气道冷冻联合氩等离子电凝治疗晚期中央型肺癌的疗效分析

目的探讨经人工气道支气管镜下冷冻联合氩等离子电凝（APC）治疗晚期中央型肺癌的可行性、安全性。方法回顾分析我院2011年2月至2012年12月经人工气道在支气管镜下对41例晚期中央型肺癌，行冷冻，并联合APC治疗的临床资料进行分析，术后一周评价疗效。评价指标包括术前、术后咳嗽、咯血、发热症状，呼吸困难指数、影像学检查、支气管镜复查气道狭窄情况等。结果患者咳嗽减轻13例（31．7％），咯血缓解14例（34．1％），发热缓解9例（22．0％），术前呼吸困难指数3．5±0．42，术后1．8±0．33；影像学提示阻塞性肺炎、肺不张消退12例（29．3％），好转27例（65．9％），无变化者2例；气管镜复查完全有效17例（41．5％），部分有效21例（51．2％），无效3例（7．3％）。结论经人工气道支气管镜下冷冻联合APC治疗中央气道肿瘤可以缓解咳嗽、咯血、发热、呼吸困难等症状，并发症少，安全性高，值得临床推广。

Curative effects of cryosurgery combined with argon plasma coagulation therapy for advanced central lung cancer by artificial trachea

Objective To assess the feasibility , safety and clinical practicality value of cryosurgery combined with argon plasma coagulation（APC） therapy via bronchofibroscope for advanced central lung cancer by artificial trachea. Methods The clinical data of 41 cases of cryosurgery combined with argon plasma coagulation therapy via bronehofibroscope for advanced central lung cancer by artificial trachea from February 2011 to December 2012 were retrospectively analyzed. The curative effects were assessed before and after treatment. There were following evaluation indicators including preoperative, postoperative cough, hcmoptysis, fever, dyspnea index, imaging examination, review of airway stenosis bronchoscopy etc. Results The research showed patients with cough relieving were 13 cases （31.7%）, hemoptysis remission in 14 cases （34.1%）, fever ease in 9 cases （22.0%） , preoperative dyspnea index 3.5 ±0.42, postoperative 1.8 ± 0.33, imaging suggestive of obstructive pneumonia and atelectasis disappeared in 12 cases（29.3% ）, 27 cases （65.9%） improved, 39 cases effective, 2 cases no changes; bronchoscope checks completely effect in 17 cases （41.5%） , partially effect in 21 cases （51.2%） , invalid in 3 cases （7.3%）. Conclusions cryosurgery combined with argon plasma coagulation therapy via bronchofibroscope for advanced central lung cancer by artificial trachea is feasible, safe and practical. It has the advantages of relieving cough, hemoptysis, fever, dyspnea, fewer complications etc, fewer complications and high security, which should be developed extensively in clinic.