激光治疗老年患者癌性气道内阻塞41例临床分析  

Laser for old patients with obstructive airway tumours.

作　　者：郭纪全[1] 陈正贤[1] 李静[1] 涂海燕[1] 李惠英[1] 

机构地区：[1]广东省人民医院呼吸科,广州510080

出　　处：《中国实用内科杂志》2005年第4期324-325,共2页Chinese Journal of Practical Internal Medicine

摘　　要：目的观察掺钕饱钇铝石榴石(Nd:YAG)激光在老年患者癌性气道内阻塞治疗中的应用价值.方法广东省人民医院于1998-06～2004-12对41例老年患者癌性气道内阻塞患者经纤维支气管镜应用Nd:YAG激光进行消融,观察其疗效及并发症.结果41例患者均良好耐受激光治疗,激光治疗后气道直径均有所扩大,扩大(6.12±1.12)mm;气促分级减少,减少(1.85±0.57)级;1秒用力呼气容积(FEV1)增加(0.62±0.16)L;动脉血氧分压(PaO2)上升(2.8±1.4)kPa.激光治疗过程中有39例患者出现短暂性低氧血症,16例出现出血,术后有13例出现早期呼吸困难,5例出现发热,心肌梗死及急性心功能不全各1例.所有并发症经积极处理后病情均保持稳定.结论Nd:YAG激光对老年人癌性气道内阻塞的治疗安全、有效.对肺功能暂时不能耐受放化疗伴癌性气道阻塞的老年肺癌患者,可以首先选择气道内Nd:YAG激光治疗,打通气道,改善肺功能及一般情况后,再选择性地进一步其它治疗.Objective To assess the efficacy of laser thera py for old patients with obstructive airway tumours.Methods 41 old patients who suffered from lung cancer with air way obstruction were treated by Nd:YAG laser through fiberbronchoscope from Apri l 1998 to February 2004.Patients' dyspnea,airway gauage,pulmonary function,blood oxygen content and complications were observed.Results All patients fully standed the laser treatments.After l aser therapy,the enlarged airway gauage averaged( 6.12±1.12)mm.The immediate relief of dyspnea was achieved in most patients,and dyspnea index lessened avera ged (1.85±0.57) grade.The obvious improvements of FEV 1 were noted al most in all patients,and the improvements averaged (0.62±0.16)L.PaO 2 ro se averaged (2.8±1.4) kPa.Complications after laser therapy included intraope rative transient hypoxemia in 39 patients,intraoperative hemorrhage in 16 patien ts,postoperative dyspnea in 13 patients,postoperative fever in 5 patients,postop erative actue myocardiac infarction and actue cardiac functional insufficiency i n one patient respectively.Conclusion Laser therapy is safe and effective in the treatmen t of old patients with carcinomatous airway obstruction.Nd:YAG laser can be firs t choice to reconstruct the occluded airway of old patients who cannot bear chem otherapy or radiotherapy,then further select other therapy.

关 键 词：气道 癌性 激光治疗 并发症 老年患者 耐受 老年人 内阻 目的观 结论 

分 类 号：R561[医药卫生—呼吸系统] R563[医药卫生—内科学]