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目的 :探讨气管腺样囊性癌的支气管镜介入治疗方法。方法 :根据支气管镜下所示气道内病变类型、部位、狭窄程度、累及范围等选择高频电刀、氩等离子体凝固、冷冻、支架置入等支气管镜介入治疗方法进行综合治疗,对患者近期及远期疗效进行评估。结果 :本组患者术中及术后未出现气胸、纵隔气肿、气管食管瘘及大出血等并发症,7例患者近期有效率为100%;均使用2种以上介入治疗方法,其中5例均1次性切除肿瘤1/2以上,2例患者因狭窄过长无法1次性切除1/2以上肿瘤,在切除部分肿瘤后置入支架;5例使用了高频电圈套器治疗,5例使用氩气刀治疗,2例使用冷冻治疗,经过2-5次治疗基本切除肿瘤,呼吸困难明显好转,气促评分为0-Ⅱ级;7例患者术后均行放疗,随访5-8月(最长随访33月)未见肿瘤复发。结论 :经软质支气管镜行综合介入治疗是气管腺样囊性癌的有效治疗方法,手术安全,近期疗效显著。
Objective: To explore the bronchoscopic interventional treatment of tracheal adenoid cystic carcinoma. Methods: According to bronchoscope showed the type of airway lesions, location, degree of stenosis, involving the scope of choice such as high-frequency electric knife, argon plasma coagulation, freezing, stenting bronchoscopy and other interventional methods for comprehensive treatment of patients with recent And long-term efficacy evaluation. Results: No complications such as pneumothorax, mediastinal emphysema, tracheal esophageal fistula and hemorrhage occurred during and after operation in this group. The effective rate was 100% in 7 patients, and more than 2 interventional treatments were used, of which 5 patients One-time resection of the tumor more than 1/2, 2 patients due to the stenosis can not be a one-time resection of more than 1/2 of the tumor, after removal of some tumors into the stent; 5 cases of high-frequency electric snare treatment, 5 The patients were treated with argon knife, 2 cases were treated with cryotherapy, and the tumors were basically resected after 2-5 times of treatment. The dyspnea of the patients was improved obviously, and the score of breathlessness was 0-Ⅱ. All the 7 patients underwent radiotherapy after operation, ranging from May to August (Longest follow-up 33 months) no tumor recurrence. Conclusion: The comprehensive interventional treatment by soft bronchoscopy is an effective treatment for tracheal adenoid cystic carcinoma. The operation is safe and the curative effect is significant in the near future.