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目的 :探索和推广一种新的治疗中晚期气管、支气管肿瘤的微创手术方法。方法 :在全麻和硬质支气管镜辅助下 ,对 2 8例中晚期气管、支气管肿瘤的非手术患者进行了气管内冷冻外科治疗。其中中心型肺癌 2 6例、支气管类癌 1例、支气管内肉芽组织增生 1例。对照观察术前、术后自觉症状及肺功能情况。结果 :自觉症状明显改善 ,改善率 :咳嗽为 6 4 .3%、呼吸困难 71.4 %、咯血 93.7%、胸痛 6 2 .5 %。肺功能也明显改善 :平均 1秒钟用力呼气量从 1.2 3L提高到 1.5 6L(P <0 .0 1) ,平均用力肺活量从 1.89L提高到 2 .12L(P <0 .0 5 )。无严重并发症和手术死亡。结论 :气管、支气管冷冻外科治疗可以迅速控制和缓解不能手术患者的自觉症状、改善肺功能 ,是一种简便、有效的微创手术方法。
Objective: To explore and promote a new minimally invasive surgery for the treatment of advanced tracheal and bronchial tumors. Methods: Twenty-eight patients with non-operative endothoracic and bronchial tumors underwent endotracheal cryosurgery assisted by general anesthesia and rigid bronchoscope. There were 26 cases of central lung cancer, 1 bronchial carcinoid and 1 case of intra-bronchial granulation tissue hyperplasia. Control observation of preoperative and postoperative symptoms and lung function. Results: The symptoms were significantly improved. The rates of improvement were: coughing of 6.43%, dyspnea of 71.4%, hemoptysis of 93.7% and chest pain of 62.5%. Pulmonary function was also significantly improved: mean forced expiratory volume per second increased from 1.2 3L to 1.5 6L (P <0.01) and mean forced vital capacity increased from 1.89L to 2.12L (P <0.05). No serious complications and surgical death. Conclusion: Tracheobronchial cryosurgical treatment can quickly control and alleviate the symptoms of inoperable patients and improve pulmonary function, which is a simple and effective minimally invasive surgical method.