【摘要】 目的观察气管镜下二氧化碳冷冻活组织检查(活检)的优势及二氧化碳冷冻消融治疗非小细胞肺癌(NSCLC)所致阻塞性肺不张的有效性和安全性。方法选择2017年6月—2019年6月石家庄市第一医院肿瘤科收治的非小细胞肺癌所致阻塞性肺不张患者77例作为研究对象,比较气管镜下普通活检组(n=35)与二氧化碳冷冻活检(冷冻活检组,n=42)检测NSCLC的成功率、安全性,观察气管镜下二氧化碳冷冻消融治疗的疗效,比较治疗前后气促评分、体质评分、KPS自由评分的差异。结果普通活检组病理诊断阳性率77.14%(27/35),冷冻活检组病理诊断阳性率97.62%(41/42),2组病理诊断阳性率比较差异有统计学意义(χ~2=7.755,P=0.005)。二氧化碳冷冻消融38例,患者气道内肿瘤清除及肺复张治疗有效率均为94.74%(36/38);其中应用喉罩下二氧化碳冷冻消融32例,耐受性良好,无明显不适主诉;硬质气管镜下二氧化碳冷冻消融6例,术后仅有轻微咽喉疼痛不适。二氧化碳冷冻消融治疗前后气促评分、体质评分和KPS自由评分比较差异均有统计学意义(P <0.05)。结论气管镜下二氧化碳冷冻活检成功率高,操作简单、安全;气管镜下二氧化碳冷冻消融能够使肿瘤快速、有效清除,对所致阻塞性肺不张能有效地复张。更多还原

【Abstract】 Objective To explore the advantages of transbronchial cryobiopsy,the safety and efficacy of transbronchial cryoablation in the treatment of obstructive atelectasis caused by non-small cell lung cancer(NSCLC) in order to improve the clinical diagnosis and treatment.Methods Seventy-seven patients with obstructive atelectasis caused by NSCLC admitted to the Oncology Department of The First Hospital of Shijiazhuang were given transbronchial cryobiopsy and transbronchial cryoablation.To compare the diagnostic rate of success and safety between transbronchial forceps biopsy(TBFB) and transbronchial cryobiopsy.Transbronchial cryoablation curative effect and score of shortness of breath were observed in each lung segment.Results Seventy seven patients were observed,of which 35 patients underwent TBFB,the pathological positive rate was77.14%(27/35).42 patients underwent TBCB,the pathological positive rate was 97.62%(41/42),significantly higher than TBFB.There was significant difference between the two groups(χ~2=7.755,P=0.005);38 patients were treated with transbronchial cryoablation.The effective rate of tracheal tumor removal and lung recruitment was 94.74%(36/38).Among them,32 cases were treated with transbronchial cryoablation under the laryngeal mask,with good tolerance and no complaints of discomfort;6 cases were treated with transbronchial cryoablation under rigid tracheoscope,and only minor sore throat was found after operation.Conclusion The advantage of bronchoscopy carbon dioxide cryobiopsy is that the biopsy success rate is high,the operation is simple and safe.Chronic carbon dioxide cryoablation under bronchoscopy can quickly and effectively remove tumors and effectively recapitulate obstructive atelectasis.更多还原