经纤维支气管镜高频电刀治疗气道内良恶性狭窄10例  

High-frequency electrocautery via fiberoptic bronchoscopy in treatment for 10 cases with airway benign and malignant stenosis

作　　者：达春和[1] 边雨田[1] 刘丽君[1] 马五一[1] 杜世霞[1] 张晓惠[1] 

机构地区：[1]甘肃省白银市第一人民医院呼吸科,730900

出　　处：《内科》2009年第5期681-682,共2页Internal Medicine

摘　　要：目的探讨经支气管镜高频电刀治疗气道内良恶性狭窄的疗效及安全性。方法对10例气道内良恶性狭窄患者经支气管镜高频电灼扩大管腔,观察近期疗效、远期疗效及安全性。结果10例病人治疗后完全通畅率53.8%,总有效率92.3%。3例5次阻塞性肺不张得到缓解,4例6次阻塞性肺炎好转;治疗前气促指数为(3.21±0.51),FVC(2.58±0.41)L,FEV1(1.63±0.25)L,治疗后气促指数为(1.51±0.60),FVC(3.05±0.32)L,FEV1(1.71±0.27)L,治疗前后差异均有统计学意义(P<0.005)。高频电刀治疗并配合放化疗可提高病人中位生存期,无出血、气胸、纵隔气肿、气管食管瘘及气管内烧伤、感染等并发症发生。结论经支气管镜高频电刀治疗气道内良恶性狭窄疗效好、并发症少,可替代部分外科手术,值得临床广泛应用。Objective To explore the clinical curative effects and safety of high-frequency electrecautery via fiberoptic bronehoscope in treatment for airway benign and malignant stenoais. Methods 10 patients with airway benign and malignant stenosis were dilated by high-frequency electrocautery via fiberoptic bronchoscope. After these operations, the short-term effects, long-term effects and safety were observed. Results The complete patency rate was 53.8% and the total effective rate was 92.3% in 10 cases. 3 patients with obstructive atelectasis had been suffered 5 times of onset were relieved ,4 patients with obstructive pneumonia had been suffered 6 times of onset were improvement, the short breath index pre-treatment was （3.21 ±0.51 ） ,FVC was （2.58 ± 0.41 ） and FEV1 was （1.63 ± 0.25 ） ,the short breath index post-treatment was （1.51 ± 0. 60 ）, FVC was （3.05 ± 0. 32 ）, FEVI was（ 1.71 ± 0.27 ） ,there were significant difference between pre-treatment and post-treatment （P 〈0.05）. Trcalmeet of high-frequency electrocantery combined with radiotherapy and chemotherapy can improved median survival time while did not lead to complications of hemorrhage, pneumothorax, pneumomediastinum, tracheeesophageal fistula,intratracheal burned and infection. Conclusions Treatment of airway benign and malignant stenosis using high-frequency electrecautery via fiberoptic bronchoscopo has a good efficacy and less complications,it maybe partly replacement surgical operation and is valuable to widespread applications in clinic.

关 键 词：支气管镜 高频电刀 气道内良恶性狭窄 

分 类 号：R562[医药卫生—呼吸系统] R734[医药卫生—内科学]