光动力疗法联合支架置入治疗食管癌所致气道狭窄的效果观察(1)
[摘要] 目的 比较单纯支架置入与光动力治疗联合支架置入治疗食管癌所致气道狭窄的效果。 方法 2009年10月～2014年10月，收集武安市第一人民医院胸外科食管癌引起中央气道狭窄患者25例，将其随机分为两组，12例(试验组)给予支架置入后行光动力治疗，13例(对照组)行单纯支架置入，比较两组患者的气促评分情况、平均稳定期、平均生存期及并发症发生率。 结果 两组的气促评分改善情况差异无统计学意义(P>0.05)；试验组患者的平均稳定期、平均生存期明显延长(P<0.05)，支气管再狭窄发生率降低(P<0.05)。 结论 光动力治疗联合支架置入是治疗食管癌所致气道狭窄的一项有效姑息治疗方法，可延长平均稳定期和平均生存期，降低支气管再狭窄发生率。
[关键词] 光动力治疗；支架置入；食管肿瘤；气道阻塞
[中图分类号] R735.1 [文献标识码] A [文章编号] 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
食管癌常侵犯气管和主支气管，导致气道狭窄，临床常出现呼吸困难，可降低患者生活质量并缩短其生存期。气管支架能扩张狭窄的管腔，缓解患者的呼吸困难症状，然而肿瘤组织生长可使支架被压扁，并可进入支架网眼而导致气道再狭窄。由于大多数患者已经过手术、放疗及化疗等多种方式综合治疗，患者体质弱而不能进一步施行上述治疗。光动力治疗(photodynamic therapy，PDT)在气管内肿物引起的气道阻塞患者中有一定效果，且不良反应小，能为大多数晚期患者所承受[1]。本研究对比单纯支架置入与PDT联合支架置入在外压性气道狭窄治疗中的作用，现报告如下。
1 资料与方法
1.1 一般资料
选取2009年10月～2014年10月在武安市第一人民医院胸外科就诊因食管癌引起的重度气道狭窄患者。入选标准：①年龄40～69岁；②中央型气道外压性狭窄75%以上；③气促评分Ⅳ级；④KPS评分>30分。排除标准：①严重心肺功能不全或全身情况极度衰弱；②远处转移。共入选25例，其中男17例，女8例，年龄47～73岁，平均62岁。将患者随机分为两组：其中13例单纯行支架置入术(对照组)，12例支架置入后行进一步行PDT(试验组)，对照组中男8例，女5例，平均年龄60.6岁，试验组中男9例，女4例，平均年龄63.5，两组的一般资料差异无统计学意义(P>0.05)，具有可比性。 (孔国平 孙健)
[关键词] 光动力治疗；支架置入；食管肿瘤；气道阻塞
[中图分类号] R735.1 [文献标识码] A [文章编号] 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
食管癌常侵犯气管和主支气管，导致气道狭窄，临床常出现呼吸困难，可降低患者生活质量并缩短其生存期。气管支架能扩张狭窄的管腔，缓解患者的呼吸困难症状，然而肿瘤组织生长可使支架被压扁，并可进入支架网眼而导致气道再狭窄。由于大多数患者已经过手术、放疗及化疗等多种方式综合治疗，患者体质弱而不能进一步施行上述治疗。光动力治疗(photodynamic therapy，PDT)在气管内肿物引起的气道阻塞患者中有一定效果，且不良反应小，能为大多数晚期患者所承受[1]。本研究对比单纯支架置入与PDT联合支架置入在外压性气道狭窄治疗中的作用，现报告如下。
1 资料与方法
1.1 一般资料
选取2009年10月～2014年10月在武安市第一人民医院胸外科就诊因食管癌引起的重度气道狭窄患者。入选标准：①年龄40～69岁；②中央型气道外压性狭窄75%以上；③气促评分Ⅳ级；④KPS评分>30分。排除标准：①严重心肺功能不全或全身情况极度衰弱；②远处转移。共入选25例，其中男17例，女8例，年龄47～73岁，平均62岁。将患者随机分为两组：其中13例单纯行支架置入术(对照组)，12例支架置入后行进一步行PDT(试验组)，对照组中男8例，女5例，平均年龄60.6岁，试验组中男9例，女4例，平均年龄63.5，两组的一般资料差异无统计学意义(P>0.05)，具有可比性。 (孔国平 孙健)