支气管肿瘤射频切除术联合冷冻疗法：一种新技术的评估
Radiofrequency resection of bronchial tumours in combination with cryotherapy: evaluation of a new technique.
作者信息
Marasso A, Bernardi V, Gai R, Gallo E, Massaglia G M, Onoscuri M, Cardaci S B
机构信息
Division of Bronchology and Pulmonology, Azienda Ospedaliera San Luigi Gonzaga, Orbassano, Torino, Italy.
出版信息
Thorax. 1998 Feb;53(2):106-9. doi: 10.1136/thx.53.2.106.
BACKGROUND
A number of treatments, including Nd-YAG laser therapy, brachytherapy, cryotherapy, electrocautery, and photodynamic therapy, can re-open the obstructed bronchial lumen in patients with inoperable obstructive bronchial tumours. None of these is considered to be a "gold standard".
METHODS
The results of a retrospective study of 98 patients treated by radiofrequency tissue ablation and subsequent cryotherapy between January 1994 and June 1995 are reported. The patients were divided in two groups according to whether they were treated either after (group 1, n = 50) or before (group 2, n = 48) radiotherapy and/or chemotherapy. Bronchoscopic follow up was performed. The intervention was considered successful if the lumen was opened by > 80% and partially successful if it was opened by > 50%.
RESULTS
In group 1 treatment was successful in 60%, partially successful in 32%, and unsuccessful in 8%. The median survival time was five months from the time of bronchoscopic surgery. In group 2 treatment was successful in 66%, partially successful in 21.5%, and unsuccessful in 12.5%, with a median survival time of 14 months from the time of bronchoscopic treatment. Forty patients (24 in group 1 and 16 in group 2) received a Dumon stent.
CONCLUSIONS
Radiofrequency bronchoscopic surgery with cryotherapy appears to be a useful technique in the treatment of tracheobronchial obstruction.
背景
包括钕钇铝石榴石激光治疗、近距离放射治疗、冷冻疗法、电烙术和光动力疗法在内的多种治疗方法，可使无法手术的阻塞性支气管肿瘤患者的阻塞支气管腔重新通畅。这些方法均未被视为“金标准”。
方法
报告了1994年1月至1995年6月期间对98例接受射频组织消融及后续冷冻疗法治疗的患者进行的回顾性研究结果。根据患者在放疗和/或化疗之前（第1组，n = 50）或之后（第2组，n = 48）接受治疗，将患者分为两组。进行了支气管镜随访。如果管腔通畅度超过80%，则认为干预成功；如果通畅度超过50%，则认为部分成功。
结果
在第1组中，治疗成功的占60%，部分成功的占32%，失败的占8%。从支气管镜手术时起，中位生存时间为5个月。在第2组中，治疗成功的占66%，部分成功的占21.5%，失败的占12.5%，从支气管镜治疗时起，中位生存时间为14个月。40例患者（第1组24例，第2组16例）植入了杜蒙支架。
结论
射频支气管镜手术联合冷冻疗法似乎是治疗气管支气管阻塞的一种有效技术。
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