Gelb A F, Epstein J D
Ann Thorac Surg. 1987 Feb;43(2):164-7. doi: 10.1016/s0003-4975(10)60388-8.
Neodymium-yttrium-aluminum-garnet laser treatments were performed in 70 patients aged 62 +/- 10 (1 SD) years for incomplete malignancy-induced obstruction of the trachea or main bronchi, or both, associated with uncontrolled cough, dyspnea, atelectasis/pneumonia, and hemoptysis. Forty-three patients had been treated with surgical techniques, chemotherapy, or radiotherapy, or all three, while 27 patients were untreated before laser therapy because of acute respiratory distress. Laser treatment produced palliative improvement in 81% of the treated group (35 of 43), with survival of 4.3 +/- 3.9 months. Unsuccessfully laser-treated patients survived 0.7 +/- 0.4 month (p less than .05). Eighty-five percent of the untreated patients (23 of 27) showed postlaser improvement, with survival of 8.5 +/- 6.9 months. Unsuccessfully laser-treated patients survived 1.4 +/- 0.6 months (p less than .05). Twenty-three of the 27 previously untreated patients underwent radiation therapy after laser treatment. Laser treatments also were administered to 23 patients aged 61 +/- 13 years with complete obstruction of the main bronchi. Of this group, 17 patients had been treated and 6 had not been treated before the laser therapy. Laser treatment was successful in 47% of the treated patients (8 of 17), but there was no difference (p greater than .05) in survival between successfully and unsuccessfully treated patients (3.0 +/- 2.5 vs. 2.9 +/- 4.6 months). Similarly, laser treatment was successful in 50% of the untreated patients (3 of 6), and there was also no difference (p greater than .05) in survival between successfully and unsuccessfully treated patients (3.4 +/- 3.5 vs. 3.5 +/- 2.8 months).(ABSTRACT TRUNCATED AT 250 WORDS)
对70名年龄在62±10(标准差1)岁的患者进行了钕钇铝石榴石激光治疗,这些患者因恶性肿瘤导致气管或主支气管不完全阻塞,或两者皆有,伴有无法控制的咳嗽、呼吸困难、肺不张/肺炎和咯血。43名患者曾接受过手术、化疗或放疗,或三者皆有,而27名患者因急性呼吸窘迫在激光治疗前未接受过治疗。激光治疗使治疗组中81%(43名中的35名)的患者症状得到缓解,生存期为4.3±3.9个月。激光治疗未成功的患者生存期为0.7±0.4个月(p<0.05)。85%(27名中的23名)未接受治疗的患者在激光治疗后症状改善,生存期为8.5±6.9个月。激光治疗未成功的患者生存期为1.4±0.6个月(p<0.05)。27名先前未接受治疗的患者中有23名在激光治疗后接受了放疗。还对23名年龄在61±13岁、主支气管完全阻塞的患者进行了激光治疗。该组中,17名患者在激光治疗前接受过治疗,6名未接受过治疗。激光治疗在47%(17名中的8名)接受过治疗的患者中取得成功,但治疗成功和未成功的患者生存期无差异(p>0.05)(3.0±2.5个月对2.9±4.6个月)。同样,激光治疗在50%(6名中的3名)未接受治疗的患者中取得成功,治疗成功和未成功的患者生存期也无差异(p>0.05)(3.4±3.5个月对3.5±2.8个月)。(摘要截选至250字)