静脉麻醉下经可弯曲电子支气管镜介入治疗重度恶性气道狭窄的临床研究  

Clinical research on interventional therapy with flexible electronic bronchoscope in patients with severe malignant tracheobronchial stenosis under intravenous anesthesia

作　　者：林卫涵[1] 郑贤勇[1] Lin Weihan;Zheng Xianyong(Respiratory Medicine,Jieyang People s Hospital, 522000 Jieyang, China)

机构地区：[1]揭阳市人民医院呼吸内科,揭阳522000

出　　处：《新医学》2018年第3期205-208,共4页Journal of New Medicine

摘　　要：目的探讨静脉麻醉下经可弯曲电子支气管镜介入治疗重度恶性气道狭窄的有效性及安全性。方法选择45例重度恶性气道狭窄导致呼吸困难患者,在静脉麻醉下经可弯曲电子支气管镜介入治疗扩张气道,比较经支气管镜介入治疗前后患者的动脉血气、呼吸困难程度、气道狭窄程度以及肿瘤患者生存质量评分(KPS)的变化情况。结果与治疗前比较,支气管镜治疗后45例重度恶性气道狭窄患者的动脉血气指标、呼吸困难程度均有所改善,患者的气道直径由(0.44±0.08)cm增加至(1.26±0.24)cm,KPS由(60.2±6.1)分提升至(79.6±8.9)分(P均<0.001)。术中患者均无不适感,术中少量出血者予止血后均未见活动性出血,术后次日有2例患者出现轻微头晕。结论支气管镜介入治疗可有效减轻重度恶性气道狭窄,缓解患者呼吸困难症状,提高患者生存质量,且安全性高。Objective To evaluate the clinical efficacy and safety of interventional therapy with flexible electronic bronchoscope in patients with severe malignant tracheobronchial stenosis under intravenous anesthesia.Methods In this study,45patients with severe malignant tracheobronchial stenosis were consecutively recruited and received interventional therapy by flexible electronic bronchoscope under intravenous anesthesia.The changes of arterial blood gas,dyspnea index,degree of airway stenosis and Karnofsky s performance scoring(KPS)were statistically compared before and after interventional treatment.Results After treatment,the arterial blood gas and dyspnea index of45patients were significantly improved.The airway diameter was increased from(0.44±0.08)cm to(1.26±0.24)cm(P<0.001.The KPS score was significantly increased from(60.2±6.1)points up to(79.6±8.9)points(P<0.001.No intraoperative discomforts were reported in all patients.Slight intraoperative bleeding was observed.No active bleeding occurred after corresponding management.At postoperative1d,two patients presented with slight dizziness.Conclusion Interventional therapy with flexible electronic bronchoscope can effectively and safely mitigate severe malignant tracheobronchial stenosis,alleviate the symptoms of dyspnea and enhance the quality of life of patients with severe malignant tracheobronchial stenosis.

关 键 词：恶性气道狭窄 静脉麻醉 支气管镜 介入治疗 

分 类 号：R730.5[医药卫生—肿瘤]