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支气管内激光治疗的适应症及结果

Indication and results of endobronchial laser therapy.

作者信息

Dierkesmann R

机构信息

Klinik Schillerhöhe, Zentrum für Pneumologie und Thoraxchirurgie, Gerlingen, Federal Republic of Germany.

出版信息

Lung. 1990;168 Suppl:1095-102. doi: 10.1007/BF02718249.

Abstract

Endobronchial laser therapy will be carried out predominantly at obstructing bronchial carcinomas of the major airways. Concerning tumors distal of the bifurcation, corresponding pre-examinations (angiography, bronchography, fluoroscopy) should make it sufficiently probable that, after the recanalization of a bronchus, the patient will have a functional benefit. At non-completely obstructing tumors an occlusion of the bronchus may be prevented by an endobronchial laser resection. Only then is scarred stenosis suitable, if it concerns membranous changes; longer stenosis bring poor long-term results only. At a larger endobronchial bleeding the laser is not suitable for controlling the hemorrhage. The long-term results of the therapy for benign endobronchial lesions are good. The results of malignant changes depend basically on the localization and on the growth rate of the tumor. With a careful selection of patients very good immediate results may be obtained at nearly all endobronchial lesions.

摘要

支气管内激光治疗主要针对大气道阻塞性支气管癌进行。对于分叉远端的肿瘤,相应的术前检查(血管造影、支气管造影、荧光镜检查)应充分证明,在支气管再通后,患者将获得功能上的益处。对于非完全阻塞性肿瘤,可通过支气管内激光切除术预防支气管阻塞。只有在涉及膜性改变的情况下,瘢痕性狭窄才适用;较长的狭窄只会带来较差的长期效果。对于较大的支气管内出血,激光不适合控制出血。良性支气管内病变的治疗长期效果良好。恶性病变的结果主要取决于肿瘤的位置和生长速度。通过仔细挑选患者,几乎所有支气管内病变都可获得非常好的即时效果。

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