25例晚期原发性气管癌支气管镜介入治疗临床分析  

Clinical analysis of 25 cases of advanced primary tracheal carcinoma interventional therapy under bronchoscope

作　　者：李亚楠[1] 周云芝 张楠 王洪武 

机构地区：[1]河北联合大学,河北唐山063009 [2]煤炭总医院肿瘤内科,北京100028 [3]煤炭总医院呼吸内科,北京100028

出　　处：《临床肺科杂志》2015年第4期619-622,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的总结25例晚期原发性气管癌的临床资料,探讨原发性气管癌支气管镜介入的诊治经验。方法回顾性分析煤炭总医院肿瘤内科自2009年9月-2013年7月收治的经支气管镜检查、病理诊断的25例晚期原发性气管癌的临床资料。结果患者年龄44-77岁,平均年龄(64.5±9.8)岁。病理组织学类型,恶性肿瘤25例,其中原发性气管鳞癌患者15例,原发性气管腺样囊性癌患者10例,无良性肿瘤患者。25例患者临床上均以不同程度的咳嗽、咯血及活动后胸闷、气促、喘鸣为最多见症状。手术治疗加支气管镜介入治疗2例,化学治疗加支气管镜介入治疗3例,放射治疗加支气管镜介入治疗1例,单纯以支气管镜下介入治疗为主19例,治疗后患者咳嗽、咯血及活动后胸闷、气促、喘鸣及生活质量明显好转。结论原发性气管癌少见,早期易被误诊,支气管镜检查及病理诊断为确诊的重要方法。手术治疗是原发性气管肿瘤的主要治疗方式,在不能手术时,放射疗法和化疗疗法是有效的治疗手段,但长期疗效是有限的,而单纯支气管镜介入治疗或联合放疗或化疗等治疗可作为晚期气管癌患者姑息治疗的重要手段。经治疗后患者的咳嗽、咯血及活动后胸闷、气促、喘鸣、气促评分及气道阻塞程度显著改善,能迅速缓解气道梗阻,改善生存期,提高生活质量。Objective To summarize the clinical data of 25 patients with advanced primary tracheal carcinoma. Methods The clinical data of 25 patients with advanced primary tracheal carcinomal from September 2009 to July 2013 were retrospectively analyzed. Results The patients aged from 44 to 77 years old,with a mean age of（ 64. 5 ± 9. 8） years old. There were 25 cases of malignant tumors,including 15 cases of primary tracheal squamous cell carcinomas and 10 cases of primary tracheal adenoid cystic carcinoma. Their early clinical symptoms were unspecific,such as cough,hemoptysis and activity chest tightness,shortness of breath and wheezing. 2 patients were given surgical therapy plus interventional bronchoscopic treatment,3 cases received chemotherapy plus interventional bronchoscopic treatment,and 1 case received radiation therapy plus interventional bronchoscopic treatment. The main therapy of 19 cases were interventional bronchoscopic treatment. After treatment,their cough,hemoptysis and activity chest tightness,shortness of breath and wheezing and quality of life were improved significantly. Conclusion Primary tracheal carcinoma is extremely rare,so its early diagnosis is critical. Bronchoscopic examination and pathological diagnosis are the important methods of diagnosis.

关 键 词：原发性气管癌 支气管镜 介入治疗 治疗效果 

分 类 号：R734.1[医药卫生—肿瘤]