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-  2016 

支气管镜介入技术在甲状腺癌侵犯气管治疗中的应用

DOI: doi:10.7507/1671-6205.2016062

Keywords: 甲状腺癌, 气管侵犯, 支气管镜, 治疗

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Abstract:

目的评价经支气管镜介入治疗甲状腺癌侵犯气管的临床效果、并发症及预后。 方法回顾性分析长海医院呼吸内科自2006年1月至2015年9月收治的43例甲状腺癌侵犯气管患者的临床资料。根据甲状腺癌侵犯气管的类型、狭窄程度、基底部情况的不同采用高频电刀、氩气刀、激光、冷冻、支架置入及放射性粒子植入进行治疗。比较介入治疗前后的气管直径、气促指数,观察介入治疗中和治疗后的并发症。 结果43例甲状腺癌侵犯气管的患者经支气管镜介入治疗,病变部位气管直径由(3.9±1.5)mm增加到(10.6±0.6)mm(t=-17.314,P < 0.000 1),气促指数由(3.3±0.7)分降低到(2.3±0.7)分(t=9.274,P < 0.000 1)。术中并发症包括出血(46.5%)、声带活动受限(4.7%)和声门水肿(7.0%)。支架置入的患者再狭窄发生率为26.7%。37例随访成功的患者治疗后中位生存期为27个月。经单因素及多因素分析,使用介入方法的种类为预后的独立危险因素(HR=0.261,P=0.036)。使用≥3种方法治疗的中位生存期为47个月,使用2种方法治疗的中位生存期为36个月,使用1种方法治疗的中位生存期为13个月。 结论对甲状腺癌侵犯气管,经支气管镜介入治疗可以有效解除气道阻塞,改善气促症状;使用多种介入方法联合治疗预后较好

References

[1]  18. Coulter TD, Mehta AC. The heat is on: impact of endobronchial electrosurgery on the need for Nd-YAG laser photoresection. Chest, 2000, 118:516-521.
[2]  20. Bai C, Dong YC, Song XL, et al. In vitro study of safety and co-efficiency of the transbronchial coagulation techniques. Chin Med J, 2013, 126:124-128.
[3]  21. Rand IA, Barber PV, Goldring J, et al. British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax, 2011, 66:1-21.
[4]  1. Wang H, Tao M, Zhang N, et al. Bronchoscopic interventions combined with percutaneous modalities for the treatment of thyroid cancers with airway invasion. Eur Arch Otorhinolaryngol, 2015, 272: 445-451.
[5]  2. Ribechini A, Bottici V, Chella A, et al. Interventional bronchoscopy in the treatment of tracheal obstruction secondary to advanced thyroid cancer. J Endocrinol Invest, 2006, 29:131-135.
[6]  3. 徐新博, 李文明, 金童, 等.分化型甲状腺癌累及喉气管的外科治疗.临床耳鼻咽喉头颈外科杂志, 2014, 28:1934-1937.
[7]  4. Gaissert HA, Honings J, Grillo HC, et al. Segmental laryngotracheal and tracheal resection for invasive thyroid carcinoma. Annals Thorac Surg, 2007, 83:1952-1959.
[8]  5. Ali MZ, Muzafar S, Umair B, et al. Tracheal resection and end-to-end anastomosis for tracheal stenosis: etiology and outcome. Acta Oto-laryngol, 2011, 129:575-579.
[9]  6. Yang R, Yu X, Ma L, et al. Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: a case report. Oncol Lett, 2012, 4:771-774.
[10]  7. Stephens KE, Wood DE. Bronchoscopic management of central airway obstruction. J Thorac Cardiovascular Surg, 2000, 119:289-296.
[11]  8. Koike E, Yamashita H, Noguchi S, et al. Bronchoscopic diagnosis of thyroid cancer with laryngotracheal invasion. Arch Surg, 2001, 136:1185-1189.
[12]  9. Stubarg R, Adams L. Textbook of respiratory medicine. Philadelphia: Saunders, 1994, 511-512.
[13]  10. Koshiishi H, Toriya K, Ozaki O, et al. Fiberoptic bronchoscopy in thyroid carcinoma with tracheal invasion. Diagn Ther Endosc, 1998, 4:113-118.
[14]  11. 童林荣, 白冲.经支气管镜高频电圈套治疗气道新生物的临床应用.临床肺科杂志, 2014, 19:1579-1581.
[15]  12. Tsutsui H, Kubota M, Yamada M, et al. Airway stenting for the treatment of laryngotracheal stenosis secondary to thyroid cancer. Respirology, 2008, 13:632-638.
[16]  13. Bolliger CT, Mathur PN. Interventional bronchoscopy. Vol.20.Basel:Karger Medical and Scientific Publishers, 2000, 133-145.
[17]  14. Jiang JH, Turner JF, Huang JA. Endobronchial ultrasound elastography: a new method in endobronchial ultrasound-guided transbronchial needle aspiration. J Thorac Dis, 2015, 7:S272.
[18]  15. 史小武, 杨钢, 赵苏, 等.气道支架治疗甲状腺癌所致气管狭窄的临床观察.中华内分泌外科杂志, 2013, 7:295-298.
[19]  16. Yuasa R, Hata Y, Otsuka H, et al. Placement of self-expandable metallic stents for tracheal stenosis secondary to thyroid cancer. Mol Clin Oncol, 2014, 2:1003-1008.
[20]  17. Bolliger CT, Sutedja TG, Strausz J, et al. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur Respir J, 2006, 27:1258-1271.
[21]  19. Noppen M, Poppe K, D'haese J, et al. Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease. Chest, 2004, 125:723-730.
[22]  22. 王洪武, 周云芝, 罗凌飞, 等.气管镜微创治疗结合放/化疗粒子植入治疗侵犯气管壁的甲状腺乳头状癌.中国肺癌杂志, 2009, 12:831-834.

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