内镜Nd∶YAG激光治疗食管和贲门早期癌的临床体会  

Endoscopic Nd∶YAG Laser Therapy for Early Esophageal and Cardiac Cancers

作　　者：王玉梅[1,2,3] 杨观瑞[1,2,3] 赵立群 贾建红[1,2,3] 李姗姗[1,2,3] 裘宋良 张杰 

机构地区：[1]河南省新乡市中心医院 [2]河南省医学科学研究所 [3]新乡市卫生局

出　　处：《中国激光医学杂志》1996年第2期67-70,共4页Chinese Journal of Laser Medicine & Surgery

摘　　要：为研究Ｎｄ∶ＹＡＧ激光治疗早期食管、贲门癌的疗效。我们观察了９例不适宜手术、３４例拒绝手术而同意接受内镜Ｎｄ∶ＹＡＧ激光治疗的疗效。采用的激光治疗仪有输出功率为７０Ｗ、脉冲时间１ｓ、光距０．５～１．０ｃｍ与输出功率３０Ｗ的二台Ｎｄ∶ＹＡＧ激光器。治疗以准接触连续扫描照射方式经１～６次（平均２．６次）激光照射，４２例（占９７．７％）癌细胞消失，无穿孔等并发症。４２例随访１０～５５个月，其中６例于治愈后３６～４０个月复查时，发现早期癌灶，经内镜激光补充治疗，癌细胞消失。其余无癌复发。Fourty three patients with early esophageal (35) or cardiac (8) carcinoma were treated by endoscopic Nd∶ YAG laser therapy, because of poor conditions, other serious diseases or refuse to surgery from April 1989 to March 1993. The patients received 1-6 sessions (mean 2 6 sessions) of treatment, respectively. Among the 43 cases, histopathological biopsy showed no cancer cells after laser therapy in 42 cases (97 7%). In another case the cancer was 5 cm ×3 cm in size and he received 6 sessions of irradiation. This patient was surgically operated because of stenosis of the esophagus. Histopathological examination revealed no cancer cells in the fibrotic scar tissue, but carcinoma in situ was found above and below the irradiated area. Neither perforation nor other serious complications occurred in this group of patients. All the 42 cured cases have been followed up for 10～55 months. Among them 36 are alive without sign of recurrence, 6 showed new cancerous lesions at 36～40 months after first laser therapy and were cured again by Nd∶YAG laser treatment. All the patients were treated without hospitalization. The therapy is well effective and simple to perform, safe and with no serious complication, as well as inexpensive in cost. Therefore, it can be considered as an excellent alternative in case of patients in poor condition or when a patient refuses to surgery.

关 键 词：食管癌 胃癌 激光疗法 

分 类 号：R735.105[医药卫生—肿瘤]