50例气管、支气管腺样囊性癌临床治疗经验分析

目的探讨气管、支气管腺样囊性癌的部分临床特征及其支气管镜腔内介入治疗的临床价值。方法纳入2010年1月至2018年7月空军军医大学唐都医院确诊并治疗随访的50例气管、支气管腺样囊性癌患者,分为支气管镜介入组(24例)及手术组(26例)。回顾性分析其部分临床特征及支气管镜腔内介入技术、手术对其治疗疗效的部分比较。结果50例病例中位年龄为49.62岁,女30例,男20例;主要症状为气短、咳嗽、咳痰,部分有咯血、胸痛;主要发病部位为气管中下段(23例);气促指数1级8例,2级18例,3级11例,4级13例。26例首次行手术治疗,24例首次行2种以上的支气管镜腔内介入治疗,2组治疗狭窄程度缓解率比较,差异无统计学意义(P=0.020);支气管镜介入组治疗前后气促指数比较,差异有统计学意义(Z=-4.622,P<0.001);手术组治疗前后气促指数比较,差异有统计学意义(Z=-5.553,P<0.001)。支气管镜介入组1例在治疗过程中有较多出血。结论气管、支气管腺样囊性癌好发于气管中下段、气短、未行手术的患者。支气管镜腔内介入治疗可降低气促指数、缓解气短,且管腔狭窄缓解程度高,值得临床推广。

Clinical experience of 50 cases of adenoid cystic carcinoma of trachea and bronchi

Objective To study the part of clinical characteristics of trachea or bronchi adenoid cystic carcinoma and clinical value of the bronchoscopy cavity interventional therapy about it.Methods This study summarized total 50 patients of tracheal or bronchus adenoid cystic carcinoma who are diagnosed,treated and carefully followed in Tangdu hospital,The Fourth Military Medical University from January 2010 to July 2018.They were divided into bronchoscope intervention group(24 cases)and operation group(26 cases)And a retrospective analysis was then performed with their part of clinical characteristics and the comparison of therapeutic effect between the bronchoscopy cavity interventional therapy and the surgery.Results There were 30 females and 20 males and the median age was 49.62 years old.The main symptoms of all 50 cases were cough,expectoration and shortness of breath and some of them also accompany with hemoptysis and chest pain.Among 50 cases,23 cases of carcinoma occurred in middle-to-lower bronchial segments,which is the largest part of all cases.8 cases scored grade Ⅰ at Borg index,18 cases scored grade Ⅱ,11 cases scored grade Ⅲ,and 13 cases scored gradeⅣ.26 patients accepted surgery for the first time,and the other 24 patients accepted more than two kinds of bronchoscopy cavity interventional therapy for the first time.And the trachea or bronchi stenosis remission rate between two groups had no statistically difference(χ^2=6.019,P=0.111).The Borg index after the bronchoscopy cavity interventional therapy(Z=-4.622,P<0.001)and the surgery(Z=-5.553,P<0.001)were both improved,and the difference was statistically significant.There was one case accepted the bronchoscopy cavity interventional therapy had a bad hemorrhage during the therapy.Conclusions Shortness of breath,unoperated patients with symptoms of bronchoscopy intervention can reduce the shortness of breath index,relieve shortness of breath,and the degree of stenosis of the humen is high.It is worthy of chlinical promotion.