Freitag Lutz
Lungenklinik Hemer, Dept. of Interventional Pneumology, D-58675 Hemer, Germany.
Lung Cancer. 2004 Aug;45 Suppl 2:S235-8. doi: 10.1016/j.lungcan.2004.07.970.
Interventional bronchoscopy has evolved as an integral part of lung-cancer treatment but it is not always used to its full potential. The different methods can provide immediate relief of dyspnea and haemoptysis. Bleeding from central airway tumours can be stopped by coagulation preferably with the argon plasma coagulator. In cases of intraluminally growing tumour masses removal of the malignant tissue is accomplished with the Nd-YAG laser, electrocautery, argon plasma coagulation, cryotherapy or photodynamic therapy. Intramural tumour growth is most efficiently treated with high dose-rate endobronchial brachytherapy. Extrinsic compression or airway wall destruction require the placement of an airway stent. All methods can be combined and complement other palliation methods such as radiation or chemotherapy.
介入性支气管镜检查已发展成为肺癌治疗不可或缺的一部分,但它的潜力并未总是得到充分发挥。不同的方法可以立即缓解呼吸困难和咯血症状。中央气道肿瘤出血最好用氩等离子体凝固器进行凝血止血。对于腔内生长的肿瘤块,可使用Nd-YAG激光、电灼、氩等离子体凝固、冷冻疗法或光动力疗法切除恶性组织。壁内肿瘤生长最有效的治疗方法是高剂量率支气管内近距离放射治疗。外部压迫或气道壁破坏需要放置气道支架。所有这些方法都可以联合使用,并补充其他姑息治疗方法,如放疗或化疗。