高频电刀氩气刀治疗伴呼吸功能不全的大气道肿瘤效果和安全性

摘要

目的：探讨经支气管镜高频电刀氩气刀治疗伴呼吸功能不全大气道肿瘤的有效性和安全性。方法分析广东医学院附属福田医院2010年9月~2014年12月19例经病理确诊的伴呼吸功能不全的晚期中央型肺癌患者的高频电刀氩气刀治疗情况。结果19例患者共进行了37次治疗,手术室全麻6人6次,其他31次均在支气管镜室非全麻下手术,25次辅助通气下进行。有效8例,部分有效7例,轻度有效3例。同时进行光动力照射治疗的有6例,置入金属支架的有1例。结论治疗大气道肿瘤伴呼吸功能不全,选择良好的麻醉和呼吸支持方式后,高频电刀氩气刀术是一种安全、有效的方法。%Objective To investigate the efficacy and safety of electrocautery and argon plasma coagulation (APC) for the therapy of central airway tumor with respiratory insufficiency. Methods The efficacy of electrocautery and APC for the therapy of 19 pathologically confirmed advanced central airway tumor with respiratory insufficiency from September 2010 to December 2014 in Affiliated Futian Hospital of Guangdong Medical College was analyzed. Results Of the 19 patients with a total of 37 treatments, 6 patients and 6 periods were in the operating room under general anesthesia;the other 31 periods were in the bronchoscopy room under potical anesthesia with sedation, 25 periods with assisted me-chanical ventilation. 8 cases were effective, 7 cases were partial response, 3 cases were mild effective. 6 cases took si-multaneous photodynamic therapy, one case took metal stent implantation. Conclusion With the proper anesthesia and respiratory support, electrocautery and APC is a safe and effective method for central airway tumor with respiratory in-sufficiency.