氩等离子体凝固术治疗气管腺样囊性癌19例效果分析  

The argon plasma coagulation in the treatment of tracheal adenoid cystic carcinoma: a clinical study of 19 cases

作　　者：朱强[1] 岳岩[1] 朱立成[2] 梁志欣[1] 陈良安[1] 杨震[1] Zhu Qiang;Yue Yan;Zhu Licheng;Liang Zhixin;Chen Liangan;Yang Zhen(Department of Pneumology,General Hospital of PLA,Beijing 100853,China;Department of Pneumology,The Third People′s Hospital of Nantong in Jiangsu Province,Nantong 226000,China)

机构地区：[1]解放军总医院呼吸科,北京100853 [2]江苏省南通市第三人民医院呼吸科,南通226000

出　　处：《中华腔镜外科杂志（电子版）》2018年第4期228-233,共6页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的评价经支气管镜氩等离子体凝固术(argon plasma coagulation,APC)在气管支气管腺样囊性癌治疗中的临床应用价值。方法回顾性分析2000年1月至2017年12月解放军总医院呼吸科收治的原发性气管支气管腺样囊性癌患者19例,其中12例气管腺样囊性癌、7例支气管腺样囊性癌,均行经支气管镜氩等离子体凝固术治疗。结果 19例患者进行了6~132个月(平均58. 11个月)的随访,定期行胸部CT和支气管镜检查,治疗后近期有效率为100%,咳嗽、胸闷、气短等症状明显改善。其中完全有效10例(53%)、部分有效5例(26%)、轻度有效4例(21%)。19例患者气促指数,治疗前(3. 5±0. 5)级、治疗后(1. 5±0. 6)级,差异有统计学意义(t=6. 2,P <0. 05)。无严重并发症。结论 APC对于气道腔内病变的治疗安全有效,可有效切除肿瘤,保证气道通畅,迅速改善临床症状,为气管支气管腺样囊性癌提供一种新的治疗选择。Objective To evaluate the clinical application value of argon plasma coagulation （APC） via bronchoscope in the treatment of tracheal adenoid cystic carcinoma. Methods From Jan. 2000 to Dec. 2017 the Chinese PLA General Hospital Department of Respiratory Medicine treated 19 patients with primary adenoid cystic carcinoma of trachea and bronchus were treated with APC via bronchoscope, including 12 cases of adenoid cystic carcinoma of trachea, 7 cases of adenoid cystic carcinoma of bronchus, and all of them treated by argon plasma coagulation （APC） via bronchoscope. Results 19 patients were followed up for 6／｜132 months （mean 58.11 months） and the recent effective rate was 100%, cough, chest tightness, shortness of breath and other symptoms improved significantly.And full effectiveness was achieved in 10 cases （53%）, partial in 5 cases （26%）, mild in 4 cases （21%）. The borg index of this 19 patients was declined from（3.5 ± 0.5）to（1.5 ± 0.6）after treatment, the difference was statistically significant （ t= 6.2 ,P 〈0.05）and no serious complications was occured. Conclusions APC via bronchoscope is an effective and safe method to treat endobronchial lesions which could resection of tumor effective , keep the airways open, improve the clinical symptoms rapidly,and provide a new treatment option for adenoid cystic carcinoma of trachea and bronchus.

关 键 词：气管支气管 腺样囊性癌 支气管镜 氩等离子体凝固术 

分 类 号：R734.1[医药卫生—肿瘤]