经纤支镜微波凝固治疗中央型肺癌的实验及临床研究

目的: 研究微波治疗中央型肺癌的安全性和治疗效果。方法: 家犬12只,用不同能量微波烧灼气管壁后观察犬的呼吸情况,1~8周分别处死,光镜和电镜观察家犬气管烧灼部位的病理变化和愈合过程。选择中央型肺癌患者90例,均有肺不张和呼吸困难,分为微波联合化疗组(治疗组)和单纯化疗组(对照组),观察患者症状的改善及胸片和胸部CT的变化,同时测定患者血液中自然杀伤细胞(NK细胞)的活性及淋巴细胞转化率。结果: 微波凝固烧伤后所有犬呼吸均正常,随后1~8周气管受灼伤部位迅速修复。治疗组所有患者症状减轻,其中35例完全复张,8例部分复张,2例无效。同时血液中NK细胞活性增加(P<0.01)。对照组仅8例部分复张,NK细胞活性降低。结论: 小于65W15s微波凝固治疗中央型肺癌是安全有效的,可显著减轻气道阻塞症状,并提高患者免疫力。

The experimental and clinical research of microwave tissue coagulation by fiberoptic bronchoscopy in treating central lung cancer

Objective:To investigate the safety and clinical effectiveness of microwave tissue coagulation(MTC) by fiberoptic bronchoscopy in treating central lung cancer.Methods:The canine respiratory was observed after microwave of various energy fire the wall of bronchus.The recovery of injury and pathological changes were observed under light microscope and electron microscope after canines were killed from 1 to 8 weeks.Lung cancer patients( n =90) with atelectasis and dyspnea were devided into two groups.One group was treated with MTC and chemotherapy(treatment group),the other group was treated only with chemotherapy(control group).The alleviating of symptom and change of X ray were observed.Activity of natural killer cell(NK cell) and lymphocyte blastagensis test(LBT) were detected.Results:All canine respiratory and the injury of bronchus were recovered quickly.Dyspnea of some cases was alleviated,activity of NK cell was elevated significantly( P <0.01) and atelectasis of patients were reinflated completely in 35 cases,reinflated partially in 8 cases in treatment group.Atelectasis of 8 cases were incompletely inflated in control group.Conclusions:MTC treatment in central lung cancer is safe and effective.MTC treatment can alleviate symptoms of airway obstruction and enhance immunity.