冷热联合消融技术在气道肿瘤中的应用

目的回顾性分析气管镜下冷热联合消融技术治疗原发气管、支气管良恶性肿瘤的应用价值。方法总结解放军第60中心医院呼吸内科2013年1月-2015年11月,30例原发气管/支气管良恶性肿瘤患者的病理类型,包括:错构瘤8例,脂肪瘤1例,肉芽肿4例,透明细胞癌1例,小细胞肺癌7例,鳞状细胞癌9例,运用内镜下二氧化碳CO2冷冻联合热消融治疗的方法及转归。结果 30例患者中男22例,女8例,病程在1个月~2年,全部患者均在局麻联合静脉麻醉下进行气管镜下介入治疗手术,均采取冷热联合消融技术。所有病例术后气道完全开通,解除了气道梗阻。其中,19例一次性手术清除病灶,8例因病灶分布广,分2次手术,3例分3次手术,术后无严重并发症,随访无复发,血气分析及呼吸困难指数均有明显改善。结论气管镜下冷热联合消融技术在治疗原发气管、支气管良恶性肿瘤疗效确切,简单、创伤小并安全。

Clinical effects of bronchoscope combined hot and cold ablation technique in benign and malignant tumors in the airway

Objective To analyze the clinical effects of bronchoscope combined with hot and cold ablation in treatment of benign and malignant tumors in primary tracheal and bronchial. Methods From January 2013 to November 2015, 30 cases of pathological types of primary tracheal / bronchial benign and malignant tumors patients include: 8 cases of hamartoma, 1 case of lipoma, 4 cases of granuloma, 1case of clear cell carcinoma, 7 cases of small cell lung cancer, 9 cases of squamous cell carcinoma, were treated by using carbon dioxide cryotherapy combined hot ablation under bronchoscope. Then investigated the outcomes. Results 30 patients, 22 males, 8 females, suffered from 1 month to 2 years, underwent surgery bronchoscope interventional treatment under local anesthesia combined with intravenous anesthesia, are taking joint cold ablation technique. All patients airway is completely opened, the lifting of the airway obstruction. Including 19 cases of disposable surgical removal of the lesion; 8 cases of lesions due to wide distribution, 2 times surgery; three cases three times surgery, no serious complications, follow-up without recurrence, blood gas analysis and dyspnea index were significantly improved. Conclusion Bronchoscope cold joint ablation techniques in the treatment of primary tracheal, bronchial benign and malignant tumors is effective, simple, minimally invasive and safe.