喉罩通气下经支气管镜钬激光治疗气道肿瘤的临床观察

为了探讨在喉罩通气下经支气管镜钬激光治疗晚期气道肿瘤的疗效、安全性和可行性,用异丙酚、瑞芬太尼和氯化琥珀胆碱行静脉全身麻醉下喉罩通气经支气管镜钬激光治疗10例气道肿瘤患者,采用美国科以人公司生产的脉冲式钬激光石英光导纤维,功率控制在8～12W,脉冲频率10～20Hz,总能量控制在10～40J,距离靶位0.5～1cm处照射治疗,每次照射3～10s,以分次照射、多次钳取坏死物交替进行。10例患者经支气管镜下16次钬激光治疗后,完全有效6例,部分有效4例,有效率100%。初步研究结果提示,喉罩通气下经支气管镜钬激光治疗气道肿瘤安全、可行,治疗效果明显,为临床治疗气道梗阻提供了一种新的治疗手段。

Investigation on the feasibility of ho-laser therapy for airway tumor with bronchoscope under laryngeal mask airway

The objective of this study was to explore the therapeutic effect,safety and feasibility of holmium laser therapy with bronchoscope under laryngeal mask airway in patient with advanced airway tumor.10 patients with airway tumor were treated by holmium laser therapy with bronchoscope under laryngeal mask airway,who received general intravenous anesthesia by Propofol,Remifentanil and Suxamethonium chloride.Pulsed-wave mode holmium laser quartz optical fiber produced by Coherent Co.USA was used in the study,whose power was controlled within 8-12 W,pulse frequency was 10-20 Hz,and total power was 10-40 J.Irradiated treatment every 3-10 seconds was provided at 0.5-1 cm distance from target site,then clamp the necrotic tissue alternately.10 patient's symptom were improved obviously after holmium laser 16 therapies with bronchoscope,complete control 6 cases,partial control 4 cases,the overall control rate was 100%,especially for those patients with no therapeutic indication and no bearing the examination and treatment with bronchoscope under local anesthesia,the clinical therapeutic effect and safety were satisfied.In conclusion,it is safe and feasible for patients with airway tumor to receive holmium laser therapy with bronchoscope under laryngeal mask airway,it is improved obviously to clinical symptom and provides a new therapeutic method for treatment of airway tumor obstruction.