目的:探讨经支气管镜高频电切和冷冻治疗在解除晚期中央型肺癌所致严重气道阻塞中的临床价值和安全性.方法:回顾性分析经支气管镜应用高频电切和冷冻技术治疗31例晚期中央型肺癌所致气道严重阻塞患者的临床资料.充分做好31例患者术前准备工作及术中监测,根据气道内肿瘤生长方式不同,选择高频电切或冷冻技术或联合治疗方法,直接切除气道内肿瘤,出血时采用高频电凝止血.结果:治疗31例总有效率(RR)为100%:完全缓解(CR)14例,部分缓解(PR)17例;31例患者呼吸困难明显改善,治疗前后气促指数评分及肺功能检查比较差异有统计学意义(P＜0.05).ECOG评分明显改善;治疗相关并发症轻微.结论:经支气管镜高频电切和冷冻治疗晚期中央型肺癌所致气道严重阻塞,可迅速缓解患者呼吸困难,改善患者生活质量,疗效确切,安全可靠.%Objective: To explore the therapeutic effects and safety of high-frequency electrocision and freezing technique via bronchofibroscope in the treatment of severe airway obstruction caused by advanced central lung cancer. Methods: Clinical features of 31 cases of advanced central lung cancer with severe airway obstruction were retrospectively analyzed. The effect and safety of high-frequency electrocision and freezing technique were evaluated. Preoperative preparation and intraoperative monitoring were necessary. According to the growth patterns of neoplasm, high-frequency electrocision, freezing and combined therapy were applied to relieve the obstruction. High-frequency electrocoagulation was used when bleeding. Results: 14 cases got complete remission, while 17 cases were partial remission. The total effective rate was 100％ ( CR + PR = 31 ). All of the 31patients received significant amelioration in ECOG scales, lung function and tachypnea index ( P ＜ 0.05 ). The complications during the whole therapy were mild. Conclusion: The high-frequency electrocision and freezing technique can relieve the dyspnea symptom quickly and remarkably improve patients' life quality which is a safe and effective way in the palliative treatment of the advanced central lung cancer.
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