内镜外科微波治疗深腔肿物的临床研究  

The clinical research of endoscopic microwave thermotherapy for treatment of tumors in deep cavity

作　　者：胡建章[1] 丁溥训[1] 张庆海 王伟[1] 陈敦淳[1] 杨萍[1] 

机构地区：[1]天津医科大学肿瘤医院内镜科,300060

出　　处：《中华物理医学与康复杂志》2002年第5期293-296,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　研究微波直接消除深腔肿物的功能保全性治疗方法 ,探究微波对于内镜外科治疗癌前病变、恶性肿物及其危重梗阻的临床价值。方法　内镜操控同轴电缆及电极直接插触呼吸道或消化道肿物 346例 ,发射适当剂量微波使病灶组织内部产生高能 ,攻击与消除肿物。随机分别设立微波气化与凝固、气化与放化疗、微波与机械钳取等对照比较疗效 ,并对计数资料行统计学分析。结果　微波治疗肿物 32 9例达CR ,仅 1 7例为PR ,全部良性肿物患者痊愈。其中 2 5例患者Ⅲ度以上喉阻塞解除 ,37例气管和支气管阻塞、37例食管贲门癌性梗阻当即复通 ,呼吸或吞咽困难危重症立即缓解 ,功能恢复。微波气化与凝固疗效比较差异有显著性 ,气化组实现速效 ,术毕肿物即已消失而治愈。气化和钳取疗效差异显著。咽喉肿物术后发音及吞咽功能恢复 ,随访 1～ 5年原部位未见复发 ,恶性者亦明显缓解 ,吸气性呼吸困难改善 ,上消化道复发癌术后KPS明显改善 ,51例患者中 46例达A级 ,手术前后比较P <0 .0 1。结肠腺瘤治疗较为彻底 ,随访 1～ 5年原部位未见复发。结论　微波气化疗法适用内镜外科功能保全微创术 ,是简捷安全的有效方法 ,对预防性治疗癌前病变防止残留及复发 ,局部切除癌肿 ,解除内腔肿物严重梗阻都显示良好效果及前景 。Objective To explore the clinical and practical validity of application of endoscopic microwave thermotherapy for treatment of deep cavity neoplasms. Methods Clinical data of 346 cases with neoplasms within the oral cavity , gastro intestinal or respiratory tract, and treated with endoscopic microwave thermotherapy, were retrospectively analysed. Results Complete resolution of tumors within the respiratory or GI tract was obtained in 329 cases . All the 246 benign pharyngeal tumors (190 cases) were eradicated following the treatment, none of them was recurrent during the 1～5 years follower up period. Satisfactory results were obtained in 37 cases with tumors of respiratory tract. For 51 patients with upper digestive tract tumor, complete resolution was achieved in 34(66%) and partial resolution in 17 (33.3%) . Excellent results were obtained in all patients with adenoma of the colon. Conclusion Endoscopic microwave thermotherapy is an simple, effective, and safe method when it is used to remove certain tumors, especially the benign ones, and those in the precancerous stage. It is also useful for eradicating tumor remnants and prevention of relapse. Not all of the neoplasms located in deep cavities can be managed by this technique, further studies are warranted before it can be extensively applied in the clinics.

关 键 词：临床研究 外科手术 内窥镜 微波疗法 消化系统肿瘤 呼吸道肿瘤 

分 类 号：R730.5[医药卫生—肿瘤]