经气管镜介入治疗气道良、恶性狭窄的价值探讨

目的探究经气管镜介入治疗在气道良、恶性狭窄的价值。方法回顾性分析本院2015年1月～2016年12月行气管镜治疗的气道良、恶性狭窄患者20例,其中良性8例,恶性12例。针对其不同病情开展不同方式治疗,观察其疗效及安全性。气道良性病变患者行冷冻、钳夹、电刀或圈套器电凝、电切治疗;食道肿瘤致使外压性狭窄患者行金属裸支架置入治疗,肺恶性病变致气道狭窄经电刀、圈套器电凝、电切、APC或冷冻治疗后置入金属裸支架治疗。叮嘱患者每半月复查气管镜,评价治疗的有效性和安全性。结果本次良、恶性狭窄治疗中,各有1例患者治疗失败,其余患者经治疗后收效甚佳。但术后良性狭窄病变患者预后效果较好,但恶性狭窄患者远期预后效果欠佳。结论经气管镜介入治疗在气道良、恶性狭窄之近期中效果甚佳,可有效保证手术效果。但经气管镜介入治疗后,良性病变远期预后效果好于恶性病变患者。

The value of bronchoscopic interventional therapy in benign and malignant stenosis of airways

Objective To explore the value of bronchoscopic interventional therapy in the treatment of benign and malignant airway stenosis.Methods 20 cases of benign and malignant stenosis of airways treated by bronchoscopy in our hospital from January 2015 to December 2016 were retrospectively analyzed,of which 8 cases were benign and 12 cases were malignant.Different treatments were conducted for different conditions,and the efficacy and safety was observed.Patients with benign airway disease were treated with freezing,clamping,electric knife or snare electrocoagulation and electrocautery.Patients with external pressure stenosis caused by esophageal cancer were treated with bare metal stents,and airway stenosis caused by malignant lung lesions was treated with bare metal stents after electric knife or snare electrocoagulation,electrocautery,APC or cryotherapy.The patients were asked to examine the bronchoscope every half month.The effectiveness and safety of treatment was evaluated.Results In the treatment of benign and malignant stenosis,there was one patient with treatment failure,respectively.The rest of the patients had good results after treatment.However,patients with benign stenosis had a good prognosis,but patients with malignant stenosis had poor long-term prognosis.Conclusion Bronchoscopic interventional therapy is very effective in airway benign and malignant stenosis in recent period,which can effectively guarantee the effect of surgery.However,after bronchoscopic interventional treatment,the long-term outcome of benign lesions is better than that of malignant lesions.