CAJ | 학술논문

目的：评价经支气管镜气管内介入治疗对中央气管腺样囊性癌的临床价值。方法对16例经支气管镜介入治疗和14例外科手术治疗的中央气管腺样囊性癌患者的临床资料进行回顾性分析。比较介入治疗组在经支气管镜介入治疗前后的气管直径、气管狭窄率、气促指数，并观察患者肿瘤复发时间、生存期，并与外科手术组作对比。结果所有患者经治疗后呼吸困难症状明显改善，介入治疗组治疗后气管直径较治疗前明显增加（P＜0.01），狭窄率明显下降（P＜0.01），气促指数明显降低（P＜0.05）。介入治疗组治疗后气管直径、狭窄率、气促指数与外科手术组比较差异均无统计学意义（P均＞0.05）。随访12～48个月，两组术后复发率比较差异无统计学（P＞0.05）。两组术后复发者均予以介入维持治疗，组间介入维持治疗次数和临床稳定时间比较差异无统计学意义（P均＞0.05）。结论对于无外科手术指征或严重呼吸困难的中央气管腺样囊性癌，气管内介入方法是迅速改善气管狭窄的有效方法；对于手术或介入术后局部复发者以介入方法维持治疗亦有较好疗效。
목적：평개경지기관경기관내개입치료대중앙기관선양낭성암적림상개치。방법대16례경지기관경개입치료화14예외과수술치료적중앙기관선양낭성암환자적림상자료진행회고성분석。비교개입치료조재경지기관경개입치료전후적기관직경、기관협착솔、기촉지수，병관찰환자종류복발시간、생존기，병여외과수술조작대비。결과소유환자경치료후호흡곤난증상명현개선，개입치료조치료후기관직경교치료전명현증가（P＜0.01），협착솔명현하강（P＜0.01），기촉지수명현강저（P＜0.05）。개입치료조치료후기관직경、협착솔、기촉지수여외과수술조비교차이균무통계학의의（P균＞0.05）。수방12～48개월，량조술후복발솔비교차이무통계학（P＞0.05）。량조술후복발자균여이개입유지치료，조간개입유지치료차수화림상은정시간비교차이무통계학의의（P균＞0.05）。결론대우무외과수술지정혹엄중호흡곤난적중앙기관선양낭성암，기관내개입방법시신속개선기관협착적유효방법；대우수술혹개입술후국부복발자이개입방법유지치료역유교호료효。
Objective Toevaluatetheclinicalvalueofinterventionaltherapeuticbronchoscopyin treatmentofcentralairwayadenoidcysticcarcinoma.Methods Clinicaldataof16patientswithcentralairway adenoid cystic carcinoma treated by interventional therapeutic bronchoscopy and 1 4 patients treated surgically were retrospectively analyzed. Tracheal diameter,rate of tracheal stenosis and dyspnea index were statistically compared before and after bronchoscope intervention. Tumor recurrence and survival time of patients were also observed.Thentheindexeswerecomparedbetweentwogroups.Results Thesymptomsofdyspneawerealle-viated in all patients after corresponding treatment. In the interventional bronchoscopy group,tracheal diameter was increased (P<0.01 ),rate of tracheal stenosis was reduced (P<0.01 )and dyspnea index was decreased (P<0.05 ). Tracheal diameter,stenosis rate and dyspnea index did not significantly differ between two groups (all P>0.05 ). After 1 2~48 months follow-up,postoperative recurrence rate did not significantly differ be-tween two groups (P>0.05 ). Recurrent patients of two groups all underwent interventional maintenance thera-py. Frequency of interventional maintenance therapy and stable clinical time did not significantly differ between twogroups(allP>0.05).Conclusion Forcentralairwayadenoidcysticcarcinomapatientswithnosurgical indications or severe dyspnea,interventional bronchoscopy is an efficacious and rapid method for alleviating air-way stenosis. For locally recurrent patients after surgical or interventional therapy,interventional therapeutic bronchoscopy exerts a relatively high efficacy.