Wang Hongwu, Li Dongmei, Zhang Nan, Zou Hang, Zhou Yunzhi, Li Jing, Liang Sujuan
Minimal Invasive Tumor Therapy Center, Meitan General Hospital, Beijing 100028, China.
Zhongguo Fei Ai Za Zhi. 2011 Aug;14(8):653-9. doi: 10.3779/j.issn.1009-3419.2011.08.04.
Obstructive atelectasis is frequently accompanied by pulmonary infection and hypoxia. The key to treating this condition is by directly reopening the obstructive airway. The aim of the present study is to explore the safety and efficacy of interventional bronchoscopy for the treatment of malignant obstructive atelectasis.
A total of 120 cases with pathology-proved malignant obstructive atelectasis were retrospectively analyzed for the treatment of argon plasma coagulation and cryosurgery under bronchoscopy. Patients' age is between 5 and 90 years old.
A total of 120 cases had 187 atelectasis originating from 98 lesions with primary airway tumors and 89 with metastases. The most common location of atelectasis was in the upper lobe in the primary group and in the single lung in the metastasis group. Although there was no significant difference in tumor debulging between the two groups, the reopening rate of atelectasis was lower in the primary group than that in the metastasis group. The Karnofsky physical score significantly increased, and shortbreath scale decreased after interventional bronchoscopy. Among the patients, 3/4 had hypoxemia and 3.4% had severe bleeding, which caused the death of 1 patient during a procedure. The mean survival time was 6 months, and the survival rate of 1 year was 27.1%.
Bronchoscopy can rapidly and effectively debulge the airway tumor and reopen the atelectasis.
阻塞性肺不张常伴有肺部感染和缺氧。治疗这种情况的关键是直接重新开通阻塞的气道。本研究的目的是探讨介入性支气管镜治疗恶性阻塞性肺不张的安全性和有效性。
回顾性分析120例经病理证实的恶性阻塞性肺不张患者，接受支气管镜下氩等离子体凝固和冷冻治疗的情况。患者年龄在5至90岁之间。
120例患者共有187处肺不张，起源于98个原发性气道肿瘤病灶和89个转移病灶。肺不张最常见的部位在原发性组为上叶，在转移组为单肺。虽然两组之间肿瘤减积无显著差异，但原发性组肺不张的重新开通率低于转移组。介入性支气管镜检查后，卡诺夫斯基身体评分显著提高，气短量表评分降低。患者中，3/4有低氧血症，3.4%有严重出血，其中1例患者在手术过程中死亡。平均生存时间为6个月，1年生存率为27.1%。
支气管镜检查可快速有效地使气道肿瘤减积并重新开通肺不张。
