硬质气管镜手术治疗大气道疾病

来源 :中国胸心血管外科临床杂志 | 被引量 : 0次 | 上传用户:wzsman
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目的总结硬质气管镜手术治疗气道良、恶性疾病的效果,探讨其在大气道内疾病治疗方面的价值。方法2002年9月至2007年11月共为44例大气道疾病患者施行硬质气管镜手术,其中原发性气管肿瘤23例,气管肿瘤术后复发2例,其他病变压迫气管11例,外伤后瘢痕形成4例,异物3例,术后肉芽肿形成1例。窄蒂的良性肿瘤行内镜下完全切除;可切除的肿瘤在硬质气管镜下清除肿瘤后开胸行气管部分切除吻合;不能切除的恶性肿瘤或外压性病变,进行气道疏通或放置支架。结果病变位于气管19例,隆突4例,左主支气管11例,右主支气管10例。良性病变17例,恶性病变27例。共进行54次手术,其中肿瘤根治性切除17次,气道疏通18次,瘢痕清除8次,异物取出3次,支架放置或取出8次。全组手术顺利,无死亡及严重并发症发生,发生轻微并发症3例。术后良性病变患者随访16例,失访1例,除3例气管外伤后瘢痕形成外,其余13例随访4~44个月,平均23.0个月,均无复发;恶性病变患者随访23例,失访4例,随访时间5~58个月,平均27.1个月,7例根治性切除的恶性肿瘤患者随访均超过1年,仍无瘤生存,无复发;其他患者随访1个月以上,效果满意。结论硬质气管镜手术治疗大气道内病变安全、可靠,效果确实,值得在临床推广。 Objective To summarize the effect of rigid bronchoscopy in the treatment of benign and malignant airway diseases and to explore its value in the treatment of airway diseases. Methods From September 2002 to November 2007, a total of 44 cases of airway disease were treated by rigid bronchoscopy. Among them, 23 cases were primary tracheal tumor, 2 cases were recurrent after tracheal tumor, 11 cases were tracheostomy in other lesions, trauma Post-scar formation in 4 cases, foreign body in 3 cases, postoperative granuloma formation in 1 case. Narrow pedicle of benign tumors underwent endoscopic resection; excision of the tumor in the hard bronchoscope after removal of the tumor thoracotomy tracheotomy; unresectable malignancies or external pressure lesions, clear or placed airway Bracket. Results The lesions were located in trachea 19 cases, carina 4 cases, left main bronchi 11 cases, right main bronchi 10 cases. 17 cases of benign lesions, 27 cases of malignant lesions. A total of 54 operations were performed, including radical resection of the tumor 17 times, airway clearance 18 times, scar removal 8 times, foreign body removal 3 times and placement or removal of the stent 8 times. The whole operation was smooth, no deaths and serious complications occurred, 3 cases had mild complications. The patients with benign lesions were followed up in 16 cases and lost in 1 case. All the 13 cases were followed up for 4 to 44 months (average 23.0 months) except for traumatic scar formation in 3 cases. There were 23 cases of malignant lesions followed up, Four patients were lost to follow-up. The follow-up time ranged from 5 to 58 months, an average of 27.1 months. Seven patients with radical resection of malignant tumors were followed up for more than one year, and remained tumor-free and had no relapse. Other patients were followed up for more than 1 month. satisfaction. Conclusion The rigid bronchoscopy is safe, reliable and effective in the treatment of airway diseases. It is worthy of clinical promotion.
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