CAJ | 학술논문

目的探讨肺癌合并上腔静脉综合征实行介入治疗的方法、疗效及安全性.方法 52例肺癌合并上腔静脉综合征(SVCS)患者接受血管腔内成形及支架置入术治疗,治疗前后测量血管梗阻远端静脉压力.对50例接受肺癌综合治疗的患者进行疗效评价.结果有50例患者成功置入血管内支架.血管梗阻远端静脉压力检测显示,术前血管梗阻远端静脉压力为(28.2±1.9)cm H2O,术后血管梗阻远端静脉压力为(8.7 ±0.5)cm H2O,差异有统计学意义(P=0.0085).血管腔内成形及支架置入术后,完全改善20例,部分改善28例,无效4例,总有效率92.3％.血管腔内成形及支架置入术后出现胸痛12例(23.1％),穿刺部位血肿5例(9.6％),发热2例(3.8％),无大出血、肺栓塞和支架移位进入心房等严重并发症.小细胞肺癌患者的客观有效率和1年生存率分别为74.1％和21.0％,非小细胞肺癌患者的客观有效率和1年生存率分别为21.7％和35.0％.结论血管腔内成形及支架置入术可作为肺癌合并SVCS患者的首选治疗.但血管腔内成形及支架置入术仅仅是一种姑息性的治疗手段,在支架置入后继续针对肿瘤的治疗十分必要.
목적 탐토폐암합병상강정맥종합정실행개입치료적방법、료효급안전성.방법 52례폐암합병상강정맥종합정(SVCS)환자접수혈관강내성형급지가치입술치료,치료전후측량혈관경조원단정맥압력.대50례접수폐암종합치료적환자진행료효평개.결과 유50례환자성공치입혈관내지가.혈관경조원단정맥압력검측현시,술전혈관경조원단정맥압력위(28.2±1.9)cm H2O,술후혈관경조원단정맥압력위(8.7 ±0.5)cm H2O,차이유통계학의의(P=0.0085).혈관강내성형급지가치입술후,완전개선20례,부분개선28례,무효4례,총유효솔92.3％.혈관강내성형급지가치입술후출현흉통12례(23.1％),천자부위혈종5례(9.6％),발열2례(3.8％),무대출혈、폐전새화지가이위진입심방등엄중병발증.소세포폐암환자적객관유효솔화1년생존솔분별위74.1％화21.0％,비소세포폐암환자적객관유효솔화1년생존솔분별위21.7％화35.0％.결론 혈관강내성형급지가치입술가작위폐암합병SVCS환자적수선치료.단혈관강내성형급지가치입술부부시일충고식성적치료수단,재지가치입후계속침대종류적치료십분필요.
Objective To investigate the method,therapeutic effect and safety of interventional therapy for lung cancer patients with superior vena cava syndrome (SVCS).Methods Fifty-two cases of lung cancer with SVCS who received interventional therapy in our hospital between Jan to Dec 2011 were included in this study.Of the 52 cases,50 cases had successfully carried out superior vena cava stent implantation.The distal venous pressure was measured before and after angioplasty,and the results were assessed by Wilcoxon matched-pairs test.In addition,the 50 patients were followed up and the therapeutic effect and postoperative survival rate were evaluated.Results The mean distal venous pressure in the 50 patients was significantly decreased from preoperative (28.2 ± 1.9) cm H2O to postoperative (8.7 ± 0.5)cm H2O (P =0.0085).The efficacy of the treatment was as follows:complete remission (20/52,38.5％),partial remission (28/52,53.8％),ineffective 4 (4/52,7.7％),and total effective rate 92.3％.The complications after angioplasty and stent implantation included chest pain (12 cases,23.1％),hematoma at the puncture site (5 cases,9.6％),and fever (2 cases,3.8％).No serious complications such as massive hemorrhage,pulmonary embolism and stent migration into the cardiac atrium were observed.The rate of postoperative restenosis was low (2/52,3.8％).For the SCLC group,the objective effective rate was 74.1％ and 1-year survival rate was 21.0％.For the NSCLC group,the objective effective rate was 21.7％and 1-year survival rate was 35.0％.Conclusions For lung cancer patients with SVCS,interventional therapy may relief obstruction effectively,promote blood flow recovery,and relieve clinical symptoms.Interventional therapy with endovascular angioplasty and stenting may be highly recommended as the first choice for palliative treatment of SVCS.It is an effective initial palliative treatment.However,subsequent comprehensive anti-tumor treatment is necessary.