目的 探討經(jīng)支氣管鏡高頻電刀治療伴大氣道阻塞的晚期中央型肺鱗癌的有效性和安全性。方法 選擇2002 年1 月至2007 年3 月在長(zhǎng)征醫(yī)院治療的95 例晚期中央型肺鱗癌患者。其中34 例伴大氣道阻塞的患者行高頻電刀聯(lián)合化療( A 組) ,61 例不伴大氣道阻塞的患者行化療( B組) ?；煼桨赴樸K或卡鉑聯(lián)合一個(gè)第三代化療制劑。結(jié)果 高頻電刀治療后, A 組患者FEV1和呼氣峰流速( PEF) 分別較術(shù)前提高41. 1% 和65. 6% 。A、B 兩組中位生存時(shí)間分別為11. 3 個(gè)月和11. 6 個(gè)月, 兩組3 個(gè)月、6 個(gè)月和12 個(gè)月生存率分別為87% 、68% 、39% 和93% 、76% 、45% 。兩組患者的生存率無(wú)明顯差異。結(jié)論 對(duì)于伴大氣道阻塞的晚期肺鱗癌患者行高頻電刀術(shù)是一種安全、有效的方法。
引用本文： 葉俊,石昭泉,李兵,修清玉. 經(jīng)支氣管鏡高頻電刀治療伴大氣道阻塞的晚期中央型肺鱗癌的臨床研究. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 09(6): 572-574. doi: 復(fù)制
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- 1. Waechter F, Passweg J, Tamm M, et al. Significant progress in palliative treatment of non-small cell lung cancer in the past decade. Chest, 2005, 127: 738-747.
- 2. Santos RS, Raftopoulos Y, Keenan RJ, et al. Bronchoscopic palliation of primary lung cancer: single or multimodality therapy?Surg Endosc , 2004, 18: 931-936.
- 3. Vonk-Noordegraaf A, Postmus PE, Sutedja TG. Tracheobronchial stenting in the terminal care of cancer patients with central airways obstruction. Chest, 2001, 120: 1811-1814.
- 4. Bolliger CT, Mathur PN, Beamis JF, et al. ERS/ATS statement on interventional pulmonology. European Respiratory Society /American Thoracic Society . Eur Respir J, 2002, 19: 356-373.
- 5. van Boxem AJ, Westerga J, Venmans BJ, et al. Photodynamic therapy, Nd-YAG laser and electrocautery for treating early-stage intraluminal cancer: Which to choose? Lung Cancer, 2001, 31: 31-36.
- 6. Boxem T, Muller M, Venmans B, et al. Nd-YAG laser vs bronchoscopic electrocautery for palliation of symptomatic airway obstruction: A cost-effectiveness study. Chest,1999, 116: 1108-1112.
- 7. Coulter TD, Mehta AC. The heat is on: Impact of endobronchial electrosurgery on the need for Nd-YAG laser photoresection. Chest,2000, 118: 516-521.
- 8. Sutedja G, van Kralingen K, Schramel F, et al. Fiberoptic bronchoscopy electrosurgery under local anesthesia for rapid palliation in patients with central airway malignancies: a preliminary report. Thorax, 1994, 49: 1243-1246.
- 9. 王辰飛, 李強(qiáng), 白沖, 等. 支氣管鏡下腔內(nèi)高頻電刀治療中央氣道良、惡性腫瘤的臨床療效. 第二軍醫(yī)大學(xué)學(xué)報(bào), 2007, 28: 554-556.
- 10. Colt HG, Harrell JH. Therapeutic rigid bronchoscopy allows level of care changes in patients with acute respiratory failure from central airways obstruction. Chest, 1997, 112: 202-206.