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投稿时间:2023-11-16 网络发布日期:2024-08-20
投稿时间:2023-11-16 网络发布日期:2024-08-20
中文摘要: 目的 探讨在非小细胞肺癌(NSCLC)晚期气道内转移患者中应用支气管镜下消融联合血管内皮抑制素局部注射的疗效及安全性。方法 回顾性选取2021年12月至2022年12月收治于安康市人民医院呼吸内科因NSCLC引起气道狭窄患者58 例。支气管镜下消融治疗的30例为对照组;镜下消融治疗联合血管内皮抑制素局部注射的28例为治疗组。记录所有患者治疗前及治疗1周后气促指数、生活质量卡氏评分(KPS评分)、疗效及术中和术后并发症。1个月后复查支气管镜,评估气道狭窄、并发症情况及疗效。结果 治疗前,两组气促指数、KPS评分对比差异无统计学意义(P>0.05);治疗后,两组气促指数下降、KPS评分升高(P<0.01),且治疗组较对照组气促指数更低(1.22±0.72 vs 1.70±0.57, t=3.334, P<0.05),KPS评分更高(85.55±7.04 vs 80.50±5.10, t=3.808, P<0.05)。1个月后经支气管镜复查,治疗组总有效率较对照组有所提高,但差异无统计学意义(64.29% vs 43.33%, χ2=2.555,P>0.05)。治疗组、对照组治疗后各19例、21例有不同程度咯血,予血凝酶、肾上腺素局部治疗后好转,无穿孔及呼吸困难。结论 支气管镜下消融联合血管内皮抑制素局部注射治疗NSCLC晚期气道内转移患者,较单纯镜下消融对改善气促、生活质量的效果更优,且不增加并发症风险,能否提高总有效率,有待进一步探讨。
Abstract:Objective To explore the efficacy and safety of bronchoscopic ablation combined with local injection of endostatin in patients with intratracheal metastasis of advanced non-small cell lung cancer(NSCLC). Methods A retrospective study was conducted on 58 patients with airway stenosis caused by NSCLC admitted to the Department of Respiratory in Ankang People's Hospital from December 2021 to December 2022. Thirty cases treated with bronchoscopic ablation alone were served as the control group, and 28 cases treated with bronchoscopic ablation combined with local injection of endostatin were served as the treatment group. Dyspnea index, Karnofsky performance scale (KPS)score, curative effect and the number of intraoperative and postoperative complications of all patients were recorded before and after 1 week of treatment. After 1 month, a bronchoscopic reexamination was performed to evaluate airway stenosis, complications and efficacy. Results Before treatment,there was no significant difference in dyspnea index and KPS score between two groups (P>0.05). After treatment, the dyspnea indexes decreased and the KPS scores increased in the two groups (P<0.01), and dyspnea index in the treatment group was lower (1.22±0.72 vs 1.70±0.57, t=3.334, P<0.05), and the KPS score was higher (85.55±7.04 vs 80.50±5.10, t=3.808, P<0.05) compared to the control group. Bronchoscopy re-examination 1 month after treatment, the total effective rate of the treatment group was slightly higher than that of the control group, but the difference was not statistically significant (64.29% vs 43.33%, χ2=2.555, P>0.05). There were 19 cases and 21 cases of hemoptysis of different degrees in the treatment group and the control group, respectively, which improved after local treatment with hemocoagulase and epinephrine, without perforation and dyspnea. Conclusion Bronchoscopic ablation combined with local injection of endostatin is more effective than endoscopic ablation in improving dyspnea and quality of life in patients with advanced NSCLC, without increasing the risk of complications, and whether it can improve the total effective rate remains to be further discussed.
keywords: Bronchoscopic ablation Endostatin Non-small cell lung cancer Intratracheal metastasis Dyspnea index Quality of life Hemoptysis
文章编号: 中图分类号:R734 文献标志码:A
基金项目:安康市科技研究发展计划项目(安科计成字〔2021〕51号)
Author Name | Affiliation |
YUAN Zhang’an, WANG Dingjun, WANG Xueli, LI Xinsheng | Department of Respiratory, Ankang People's Hospital, Ankang, Shaanxi 725000, China |
引用文本:
袁章安,汪定军,王雪丽,李新胜.支气管镜下消融联合血管内皮抑制素局部注射对非小细胞肺癌晚期气道内转移的疗效[J].中国临床研究,2024,37(8):1249-1253.
袁章安,汪定军,王雪丽,李新胜.支气管镜下消融联合血管内皮抑制素局部注射对非小细胞肺癌晚期气道内转移的疗效[J].中国临床研究,2024,37(8):1249-1253.