摘要
目的:探讨原发性气管肿瘤的诊断和治疗方法,以及呼吸介入治疗的应用价值。方法:回顾性分析温州医科大学附属第一医院呼吸内科2003-2009年间原发性气管肿瘤14例的诊断和治疗经过。结果:14例患者临床上均以不同程度的咳嗽、呼吸困难为主。病理组织学类型,恶性9例,以鳞癌、腺样囊性癌为主,良性肿瘤5例,包括:梭形细胞肿瘤、脂肪瘤和软骨瘤等。14例中9例患者接受外科根治性手术,其中5例合用呼吸介入治疗;另5例以呼吸介入治疗为主。呼吸介入治疗在气管插管或喉罩或低位气管切开下进行,方法以高频电凝和氩气刀为主,患者选择以良性肿瘤或恶性肿瘤的姑息治疗或外科根治性术前开放气道降低麻醉风险的目的为主。结论:原发性气管肿瘤临床症状无特异性。对高度怀疑气管肿瘤者及时行颈段CT和支气管镜检查。外科手术切除为最主要的治疗方法,但呼吸介入技术对良性肿瘤的治疗、外科术前开放气道、恶性肿瘤的姑息治疗起着一定的作用。
Objective： To explore the clinical characteristics and methods of therapy of primary tracheal tumors, especially appropriate indications and the role of interventional bronchoscopy. Methods： A retrospective analysis of the clinical data of 14 patients with primary tracheal tumors admitted to our department during the period of 2003 to 2009 was performed, all cases had detailed chest radiography, bronchoscopy and pathologic diagnosis. Results： Early clinical symptoms of all cases are unspecific, including cough and dyspnea. The majority malignant tumors included squamous cell carcinomas and adenoid cystic carcinomas; benign tumors consisted of pleiomorphic adenoma, leiomyoma, Chondroma, etc. Nine cases received surgery, and 5 of 9 received interventional bronchoscopic techniques at the same time; and the main therapy of another 5 cases were interventional bronchoscopic treatment. And the main interventional bronchoscopic techniques consisted of electrocoagulation and argon-beam coagulation. The main goal of interventional bronchoscopic treatment included benign tracheal tumors and keeping the airway open before sugery and as palliative therapy of advanced malignant tumors. Conclusion： Among primary tracheal tumors, we must pay more attention to the nonspecific symptoms. Surgery should be considered as the first choice of treatment, and interventional bronchoscopic techniques can be used in the diagnosis and provide treatment of endobronchial benign tumours, and as a way to keep the airway open until subsequent definitive resection can be done or as palliative theraov of unresectable malignant tumors.
出处
《温州医学院学报》
CAS
2013年第7期478-480,485,共4页
Journal of Wenzhou Medical College
