目的 探讨支气管镜植入放射性125I粒子治疗中央型肺癌合并肺不张的近期疗效及安全性.方法 对21例确诊为中央型肺癌的患者行支气管镜植入放射性125I粒子治疗,选取肿瘤表面12:00、3:00、6:00、9:00或中心部位为穿刺点,顺序刺入病灶内部后保持各粒子间距0.5 cm左右,植入6~10粒.患者术后2周观察咳嗽及气促指数.术后1个月行支气管镜检查观察支气管管腔扩张变化,复查胸部CT检查肺不张复张情况.结果 2周后患者咳嗽较术前减轻,气促指数分级好于术前(P<0.01).与术前相比,术后支气管管腔扩大者18例、管腔内新生物完全消失者6例;术后1个月行胸部CT检查,术后肺完全复张者13例,部分复张者8例.所有患者随访时间6~24个月,中位生存期12个月,且并发症少.结论 经支气管镜植入放射性125I粒子治疗中央型肺癌合并肺不张近期疗效肯定、操作安全.%Objective To investigate short-term efficacy and safety of bronchoscope implantation radioactive 125I particle in the treatment of central type lung cancer with atelectasis.Methods Bronchoscopy implantation radioactivity 125I particles were used for treatment of 21 patients with central lung cancer.The puncture points were selected at 12:00,3:00, 6:00,9:00 on the center of the tumor surface.After penetrating into the lesions,each particle distance was kept about 0.5 cm,and 6-10 particles were implanted.The cough and gasp index were observed in patients after 2 weeks of surgery.The bronchial lumen dilatation variety was observed by bronchoscopy 1 month after surgery. The chest CT was re-checked to review the situation of atelectasis. Results The cough and gasp index were reduced 2 weeks after surgery (P<0.01). Compared with preoperation,18 cases showed bronchial lumen enlarged and 6 cases showed the lumen new biological mass disappeared completely after operation. The chest CT scan one month after surgery showed that atelectasis re-expansion completely in 13 cases,partial re-expansion in 8 cases.All of patients were followed up for 6 to 24 months,and the median survival was 12 months with less complications. Conclusion The bronchoscope implantation radioactive 125I particles are effective and safe for treatment of central type lung cancer with atelectasis.
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