CAJ | 학술논문

目的评价经气管镜介人治疗气管腺样囊性癌的临床效果、并发症.方法回顾分析北京天坛医院呼吸内科自2004年至2010年收治的气管腺样囊性癌患者共12例,比较支气管镜介入治疗前后的气管直径、气促评分,并观察治疗后的并发症.结果所有患者经治疗后症状均迅速改善,气管直径由术前的(2.61±0.78)mm扩大至(12.92±2.87)mm(P＜0.001),气促评分由术前的3.92±0.28降至术后1.08±0.90(P＜0.001).术中主要不良反应为出血,术后不良反应有咯血、胸痛、咽痛、咳嗽,远期不良反应主要为肿瘤和肉芽组织导致气管再狭窄.覆膜支架并不能减少肉芽组织增生导致的再狭窄问题,并且更易导致排痰不畅、支架移位等并发症.结论对于无外科手术指征的气管腺样囊性癌,经支气管镜介入治疗是改善气道狭窄的有效方法,如需置人气管支架时,在国内现有条件下,宜选择无覆膜的金属支架.
목적 평개경기관경개인치료기관선양낭성암적림상효과、병발증.방법 회고분석북경천단의원호흡내과자2004년지2010년수치적기관선양낭성암환자공12례,비교지기관경개입치료전후적기관직경、기촉평분,병관찰치료후적병발증.결과 소유환자경치료후증상균신속개선,기관직경유술전적(2.61±0.78)mm확대지(12.92±2.87)mm(P＜0.001),기촉평분유술전적3.92±0.28강지술후1.08±0.90(P＜0.001).술중주요불량반응위출혈,술후불량반응유각혈、흉통、인통、해수,원기불량반응주요위종류화육아조직도치기관재협착.복막지가병불능감소육아조직증생도치적재협착문제,병차경역도치배담불창、지가이위등병발증.결론 대우무외과수술지정적기관선양낭성암,경지기관경개입치료시개선기도협착적유효방법,여수치인기관지가시,재국내현유조건하,의선택무복막적금속지가.
Objective To evaluate the effects and complications of interventional therapy by bronchoscopy on trachea adenoid cystic carcinoma. Methods The trachea diameter and dyspnea index of twelve patients with trachea adenoid cystic carcinoma were detected before and after treatment. The complications of therapy were observed. Results The symptoms of all patients were rapidly improved after treatment. The trachea diameter increased from (2.61±0.78) mm to (12.92±2.87) mm (P＜0. 001), and the dyspnea index decreased from 3. 92±0. 28 to 1.08±0.90 ( P ＜0. 001). In operation,the main complication was haemorrhage. After operation, the complications were haemoptysis, chest pain, pharynx pain, and cough. The long-term adverse reaction was trachea restenosis caused by tumor and granulation tissue. The tectorial membrane stent did not reduce the incidence of restenosis caused by proliferation of granulation tissue, and easily led to poor expectoration, stent migration, and other complications. Conclusions For trachea adenoid cystic carcinoma without surgery indications,interventional therapy by bronchoscopy is effective to improve airway stenosis. In China, if the trachea stent is needed, the naked metal stent is appropriate.