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气管和支气管阻塞患者支气管镜激光治疗的疗效与安全性:一项单机构回顾性报告

Efficacy and safety of bronchoscopic laser therapy in patients with tracheal and bronchial obstruction: a retrospective single institution report.

作者信息

Hermes Andreas, Heigener David, Gatzemeier Ulrich, Schatz Joachim, Reck Martin

机构信息

Department of Thoracic Oncology, Grosshansdorf Hospital, Grosshansdorf, Germany.

出版信息

Clin Respir J. 2012 Apr;6(2):67-71. doi: 10.1111/j.1752-699X.2011.00247.x. Epub 2011 Jun 27.

Abstract

PURPOSE

The aim of this retrospective study is to present data efficacy and safety of bronchoscopic laser therapy in patients with tracheal and bronchial obstruction.

PATIENTS AND METHODS

From February 2004 to April 2010, our electronic database was searched for all patients who had undergone bronchoscopic laser therapy. We collected data on age, gender, performance status, diagnosis leading to bronchoscopic laser treatment, number of procedures per patient, efficacy by means of extend of recanalisation and symptom improvement, additional interventions and procedure-related complications.

RESULTS

Two hundred fifty-six procedures were performed in 121 patients. 17% of obstructions were localised in the trachea, 57% in main bronchi and 26% in lobar bronchi including right intermedius bronchus. The sum of complete and partial recanalisation reached 95%, 80% and 68%, respectively. 26% of interventions in lobar bronchi were undertaken to treat haemoptysis which could be controlled in all cases. Moderate bleeding occurred in 6%; severe bleeding in 1%. Cardiac arrhythmias were seen in 2%. We observed one treatment-related death (overall mortality 0.4%).

CONCLUSION

Bronchoscopic laser therapy is a generally safe and effective method to regain airway patency in cases with tracheal or bronchial obstruction and to treat haemoptysis. We observed clinical improvement in terms of reduced dyspnea or controlled haemoptysis in 93% of our patients.

摘要

目的

本回顾性研究旨在呈现气管镜激光治疗气管和支气管阻塞患者的数据有效性及安全性。

患者与方法

2004年2月至2010年4月,在我们的电子数据库中检索所有接受气管镜激光治疗的患者。我们收集了患者的年龄、性别、身体状况、导致气管镜激光治疗的诊断、每位患者的治疗次数、通过再通程度和症状改善衡量的疗效、额外干预措施及与治疗相关的并发症。

结果

121例患者共进行了256次治疗。17%的阻塞位于气管,57%位于主支气管,26%位于叶支气管(包括右中间支气管)。完全再通和部分再通的总和分别达到95%、80%和68%。叶支气管治疗中26%是为了治疗咯血,所有病例均能得到控制。中度出血发生率为6%;严重出血发生率为1%。心律失常发生率为2%。我们观察到1例与治疗相关的死亡(总死亡率0.4%)。

结论

气管镜激光治疗是恢复气管或支气管阻塞患者气道通畅及治疗咯血的一种总体安全有效的方法。我们观察到93%的患者在呼吸困难减轻或咯血得到控制方面有临床改善。

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