光動力療法聯(lián)合支架置入治療食管癌所致氣道狹窄的效果觀察(1)
[摘要] 目的 比較單純支架置入與光動力治療聯(lián)合支架置入治療食管癌所致氣道狹窄的效果。 方法 2009年10月～2014年10月，收集武安市第一人民醫(yī)院胸外科食管癌引起中央氣道狹窄患者25例，將其隨機分為兩組，12例(試驗組)給予支架置入后行光動力治療，13例(對照組)行單純支架置入，比較兩組患者的氣促評分情況、平均穩(wěn)定期、平均生存期及并發(fā)癥發(fā)生率。 結(jié)果 兩組的氣促評分改善情況差異無統(tǒng)計學意義(P>0.05)；試驗組患者的平均穩(wěn)定期、平均生存期明顯延長(P<0.05)，支氣管再狹窄發(fā)生率降低(P<0.05)。 結(jié)論 光動力治療聯(lián)合支架置入是治療食管癌所致氣道狹窄的一項有效姑息治療方法，可延長平均穩(wěn)定期和平均生存期，降低支氣管再狹窄發(fā)生率。
[關(guān)鍵詞] 光動力治療；支架置入；食管腫瘤；氣道阻塞
[中圖分類號] R735.1 [文獻標識碼] A [文章編號] 1674-4721(2015)05(b)-0057-04
Effect observation of photodynamic therapy combined with stent implantation in the treatment of airway stenosis caused by esophageal cancer
KONG Guo-ping SUN Jian▲
Department of Thoracic Surgery，the First People′s Hospital of Wuan City in Hebei Province，Wuan 056300，China
[Abstract] Objective To compare the effect of simple stent implantation and photodynamic therapy (PDT) combined with stent implantation in the treatment of airway stenosis caused by esophageal cancer. Methods From October 2009 to October 2014，25 patients with central airway stenosis caused by esophageal cancer treated in department of thoracic surgery of the First People′s Hospital of Wuan City were selected and they were randomly divided into two groups.12 patients (experimental group) were given PDT after stent implantation，while the other 13 patients (control group) was given simple stent implantation.Shortbreath score，mean stable time，mean survival time and incidence rate of complication between two groups was compared respectively. Results There was no statistical difference of shortbreath score between two groups (P>0.05).Mean stable time and mean survival time was significantly proloned in patients of experimental group and incidence rate of bronchial stenosis again was obviously decreased (P<0.05). Conclusion Photodynamic therapy combined with stent implantation is an effective palliative treatment method of treating airway stenosis caused by esophageal cancer and it can prolong the stable time and mean survival time，and reduce the incidence rate of bronchial stenosis again.
[Key words] Photodynamic therapy；Stent implantation；Esophageal neoplasm；Airway obstruction
食管癌常侵犯氣管和主支氣管，導(dǎo)致氣道狹窄，臨床常出現(xiàn)呼吸困難，可降低患者生活質(zhì)量并縮短其生存期。氣管支架能擴張狹窄的管腔，緩解患者的呼吸困難癥狀，然而腫瘤組織生長可使支架被壓扁，并可進入支架網(wǎng)眼而導(dǎo)致氣道再狹窄。由于大多數(shù)患者已經(jīng)過手術(shù)、放療及化療等多種方式綜合治療，患者體質(zhì)弱而不能進一步施行上述治療。光動力治療(photodynamic therapy，PDT)在氣管內(nèi)腫物引起的氣道阻塞患者中有一定效果，且不良反應(yīng)小，能為大多數(shù)晚期患者所承受[1]。本研究對比單純支架置入與PDT聯(lián)合支架置入在外壓性氣道狹窄治療中的作用，現(xiàn)報告如下。
1 資料與方法
1.1 一般資料
選取2009年10月～2014年10月在武安市第一人民醫(yī)院胸外科就診因食管癌引起的重度氣道狹窄患者。入選標準：①年齡40～69歲；②中央型氣道外壓性狹窄75%以上；③氣促評分Ⅳ級；④KPS評分>30分。排除標準：①嚴重心肺功能不全或全身情況極度衰弱；②遠處轉(zhuǎn)移。共入選25例，其中男17例，女8例，年齡47～73歲，平均62歲。將患者隨機分為兩組：其中13例單純行支架置入術(shù)(對照組)，12例支架置入后行進一步行PDT(試驗組)，對照組中男8例，女5例，平均年齡60.6歲，試驗組中男9例，女4例，平均年齡63.5，兩組的一般資料差異無統(tǒng)計學意義(P>0.05)，具有可比性。 (孔國平 孫健)
[關(guān)鍵詞] 光動力治療；支架置入；食管腫瘤；氣道阻塞
[中圖分類號] R735.1 [文獻標識碼] A [文章編號] 1674-4721(2015)05(b)-0057-04
Effect observation of photodynamic therapy combined with stent implantation in the treatment of airway stenosis caused by esophageal cancer
KONG Guo-ping SUN Jian▲
Department of Thoracic Surgery，the First People′s Hospital of Wuan City in Hebei Province，Wuan 056300，China
[Abstract] Objective To compare the effect of simple stent implantation and photodynamic therapy (PDT) combined with stent implantation in the treatment of airway stenosis caused by esophageal cancer. Methods From October 2009 to October 2014，25 patients with central airway stenosis caused by esophageal cancer treated in department of thoracic surgery of the First People′s Hospital of Wuan City were selected and they were randomly divided into two groups.12 patients (experimental group) were given PDT after stent implantation，while the other 13 patients (control group) was given simple stent implantation.Shortbreath score，mean stable time，mean survival time and incidence rate of complication between two groups was compared respectively. Results There was no statistical difference of shortbreath score between two groups (P>0.05).Mean stable time and mean survival time was significantly proloned in patients of experimental group and incidence rate of bronchial stenosis again was obviously decreased (P<0.05). Conclusion Photodynamic therapy combined with stent implantation is an effective palliative treatment method of treating airway stenosis caused by esophageal cancer and it can prolong the stable time and mean survival time，and reduce the incidence rate of bronchial stenosis again.
[Key words] Photodynamic therapy；Stent implantation；Esophageal neoplasm；Airway obstruction
食管癌常侵犯氣管和主支氣管，導(dǎo)致氣道狹窄，臨床常出現(xiàn)呼吸困難，可降低患者生活質(zhì)量并縮短其生存期。氣管支架能擴張狹窄的管腔，緩解患者的呼吸困難癥狀，然而腫瘤組織生長可使支架被壓扁，并可進入支架網(wǎng)眼而導(dǎo)致氣道再狹窄。由于大多數(shù)患者已經(jīng)過手術(shù)、放療及化療等多種方式綜合治療，患者體質(zhì)弱而不能進一步施行上述治療。光動力治療(photodynamic therapy，PDT)在氣管內(nèi)腫物引起的氣道阻塞患者中有一定效果，且不良反應(yīng)小，能為大多數(shù)晚期患者所承受[1]。本研究對比單純支架置入與PDT聯(lián)合支架置入在外壓性氣道狹窄治療中的作用，現(xiàn)報告如下。
1 資料與方法
1.1 一般資料
選取2009年10月～2014年10月在武安市第一人民醫(yī)院胸外科就診因食管癌引起的重度氣道狹窄患者。入選標準：①年齡40～69歲；②中央型氣道外壓性狹窄75%以上；③氣促評分Ⅳ級；④KPS評分>30分。排除標準：①嚴重心肺功能不全或全身情況極度衰弱；②遠處轉(zhuǎn)移。共入選25例，其中男17例，女8例，年齡47～73歲，平均62歲。將患者隨機分為兩組：其中13例單純行支架置入術(shù)(對照組)，12例支架置入后行進一步行PDT(試驗組)，對照組中男8例，女5例，平均年齡60.6歲，試驗組中男9例，女4例，平均年齡63.5，兩組的一般資料差異無統(tǒng)計學意義(P>0.05)，具有可比性。 (孔國平 孫健)