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喉罩通气全麻下支气管镜介入治疗中央型肺癌重新投稿
High-frequency electrocautery via bronchoscopy in treatment of Central Lung Carcinoma

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DOI:
作者:
彭春燕, 彭清臻, 谢志斌, 历银平, 黄文军, 钟敏华
Peng Chunyan, Peng Qingzhen，Xie Zhibin,etal
作者单位:
孝感市中心医院
Dept．of Respiratory，The Central Hospital of Xiaogan
关键词:
高频电刀术；支气管镜；喉罩；机械通气；中央型肺癌
High-frequency electrocautery；bronchoscopy； Laryngeal mask； Mechanical ventilation； Central lung neoplasma
摘要:
目的：探讨全麻下经喉罩联合机械通气及支气管镜下高频电刀治疗晚期中央型肺癌的临床应用价值。方法：对18例由于晚期肺癌致中心气道狭窄的患者在全麻下经喉罩联合机械通气行电子支气管镜下腔内高频电治疗，观察疗效及并发症 结果： l8例患者治疗后完全通畅率44.4％，近期总有效率为94.4％，仅一例发生严重并发症。治疗前气道腔径 (3.12±1.47) mm，气促评分 (3.58±0.85)级，Kamofsk评分(53.0±10.00)，FEV1(1.43±0.65)L，FVC(1.86±0.18)L，治疗后气道腔径(10.04±3.50)mm，气促评分(1.18±0.95)级，Kamofsk评分(75.0±13.00)，FEV1 (2.14±0.68) L，FVC (3.03±0.23) L；治疗前后差异均有统计学意义(P＜0.05)。结论：全麻下经喉罩联合机械通气行电子支气管镜下腔内高频电刀治疗晚期中央型肺癌，能迅速缓解患者呼吸困难症状，改善生活质量，并发症少， 值得临床推广。
Objective To investigate the value in treatment of Central Lung Carcinoma by high-frequency electrocautery via bronchoscopy applying laryngeal mask during general anesthesia using mechanical ventilation.Methods Eighteen advanced stage Central Lung Carcinoma were treated by high-frequency electrocautery via bronchoscopy,observing the curative effect and complication. Results The complete pateney rate was 44.4％and the total effective rate was 94.4％in 18 cases. hemorrhage happened in observing the curative effect and complication．The airway dinmeter pre-treatment was(3.12±1.47) mm,short breath index was(3.58±0.85),Kamofsk evaluation was(53.0±10.00), FEVl was (1.43±0.65)and FVC was(1.86±0.18)，The airway dinmeter post-treatment was(10.04±3.50),short breath index was(1.18±0.95),Kamofsk evaluation was(75.0±13.00), FEVl was (2.14±0.68)and FVC was(3.03±0.23)，there were significant difference between pre-treatment and post-treatment(P<0．05).Conclusion High-frequency electrocautery via bronchoscopy in treatment of Central Lung Carcinoma by laryngeal mask combined with mechanical ventilation during general anesthesia.It can rapidly relieve symptom resulted from obstruction of tracheobrochial neoplasms,has fewer complications and favorable clinical effects.

 

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