【摘要】 目的 观察置入NT-支架后行腔内192IY放疗加体外照射治疗大气道阻塞晚期肺癌患者的疗效。方法 将40例晚期肺癌患者，随机分为观察组(20例)与对照组(20例)。观察组采用NT-支架及置入器，通过纤维支气管镜直视下无X线监视及钢丝引导，置入气道狭窄处，退出置入器，将施源器经纤维支气管镜活检管道插至肿瘤所致狭窄部位，然后遥控后装机，使192Ir进入该处行腔内放疗。腔内放疗结合体外照射，二者交叉进行。对照组只单纯行体外照射，1个月后，两组患者均行全身静脉化疗，化疗方案相同。结果 观察组20例，完全缓解7例(35%)，部分缓解11例(55%)，无变化及恶化共2例(10%)，有效率90%，明显高于对照组的60%，P<0.05。结论 置入NT-支架后，能即刻解除患者的呼吸困难，行腔内加体外照射明显缓解因肺癌支气管内复发或其他部位肿瘤转移到气管、支气管树所引起的阻塞症状，其客观疗效及症状缓解均优于单纯体外照射。

    

【Abstract】 Objective For the purpose to observe theeffectiveness of treatment in late stage patients with bronchogenic carcinoma byimplanting nitinol alloy endotrachial stent, combined with endobronchial 192 iridium (Ir)and percutaneous radiotherapy. Methods The nitiol alloy endotrachialstent was put into the site of airway stenosis through a special introducer under directoptical fibrobronchoscopy without the help of X-ray examination nor guided steel-line. 192Ir was inserted to the site of tumor via bronchofiberscope for endobronchial irradiationcombining with percutaneous radiotherapy alternately. Results In all 20patients, 7 cases (35%) were completely cured and 11 cases (55%) showed partial recovery.The other 2 cases, no change or deteriorated. The 90% effective rate was significantlyhigher than 60% of control group (P<0.05). Conclusions Dyspnea ofpatients could be immediately relieved after endobronchial stent was inserted. Combinedendobronchial and percutaneous radiotherapy obviously alleviated the obstruction caused bytrachial or bronchial neoplasms. The results suggested the combined therapy led to muchbetter objective therapeutic effect and symptomatic relief than single percutaneousradiotherapy.

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