苗春兴?金宇斌?张霞?马德爽

[摘要] 目的 探討经纤维支气管镜冷冻治疗晚期中央型肺癌对患者临床症状的影响。 方法 60例晚期中央型肺癌患者随机分为治疗组和对照组，每组30例。治疗组进行纤维支气管冷冻治疗，对照组进行常规化疗。观察患者手术前后临床症状的变化和并发症的发生情况。 结果 治疗组患者治疗后临床症状得到了明显改善，咳嗽有效率为81.25%，咯血有效率为81.82%，呼吸困难有效率为78.57%，发热有效率为85.71%，阻塞性肺炎有效率为89.47%，总有效率为96.67%；而对照组各项症状改善状况为：咳嗽有效率为47.06%，咯血有效率为38.46，呼吸困难有效率为38.46，28.57%患者发热减轻，47.62%患者阻塞性肺炎减轻，总有效率为66.67%；治疗组患者肺部肿块直径减小。术中和术后有并发症发生，经过对症治疗后基本消除。 结论 经纤维支气管镜冷冻治疗晚期中央型肺癌，患者的临床症状明显改善，生活质量大幅度提高，是一种方便快捷、安全有效的治疗方法。

[关键词] 纤维支气管镜；冷冻治疗；晚期中央型肺癌；临床症状

[中图分类号] R734.2 [文献标识码] A [文章编号] 2095-0616（2017）07-196-04

Analysis on effect of cryotherapy by fiber bronchoscope on clinical symptoms of patients with advanced stage central type lung cancer

MIAO Chunxing1 JIN Yubin1 ZHANG Xia1 MA Deshuang2

1.Department of Thoracic Surgery，Second Hospital to Mudanjiang Medical University，Mudanjiang 157000，China； 2.Department of Urinary Surgery，Second Hospital to Mudanjiang Medical University，Mudanjiang 157000，China

[Abstract] Objective To explore the effect of cryotherapy by fiber bronchoscope on clinical symptoms of patients with advanced stage central type lung cancer. Methods 60 patients with advanced stage central type lung cancer were randomly divided into the treatment group and the control group，with 30 in each group.The treatment group was given cryotherapy by fiber bronchoscope while the control group was given routine chemotherapy.Changes of clinical symptoms before and after operation and the occurrence of complications of patients were observed. Results After treatment，clinical symptoms of patients in the treatment group were significantly improved.Effective rates of cough，hemoptysis，dyspnea，fever，obstructive pneumonia of the treatment group were 81.25%，81.82%，78.57%，85.71% and89.47% respectively.And the total effective group was 96.67%.While Effective rates of cough，hemoptysis and dyspnea of the treatment group were 47.06%，38.46% and 38.46% respectively.Fever of 28.57% patients and obstructive pneumonia of 47.62% patients were both alleviated.And the total effective group was 66.67%.Complications appeared during operation and after operation and they were basically eliminated. Conclusion Cryotherapy by fiber bronchoscope for patients with advanced stage central type lung cancer，clinical symptoms of patients and quality of life of patients were both significantly improved.It is a convenient， effective and safe treatment method.

[Key words] Fiber bronchoscope；Cryotherapy；Advanced stage central type lung cancer；Clinical symptoms

肺癌是我国常见恶性肿瘤之一，患者就诊时多为晚期，失去了最佳的治疗时机。晚期中央型肺癌患者多数存在咳嗽、气短、咯血、呼吸困难和阻塞性肺炎等症状，严重影响患者的生活质量。常规的手术或放化疗不良反应大，治疗不当还会加重病情[1]。

随着腔道内窥镜介入治疗技术的发展和广泛应用，气道阻塞物可通过激光、微波、电热、冷冻及光动力学等消融技术进行治疗[2]。……