经电子支气管镜氩等离子体凝固联合高频电刀治疗气道狭窄的临床疗效分析

盛怡俊 王赛斌 涂军伟 周韧志

[摘要] 目的 探讨经电子支气管镜氩等离子体凝固（argon plasma coagulation，APC）联合高频电刀治疗气道狭窄的临床价值。 方法 研究对象选择2015年6月～2017年6月我院收治的气管、支气管恶性狭窄患者64例，采用随机数字表法将所有患者分为对照组和观察组，每组各32例。对照组患者给予高频电刀治疗，观察组患者给予APC+高频电刀治疗。比较两组临床疗效，同时比较两组治疗前后气促指数、肺功能FEV1、气道直径、气道横截面积及生活质量评分。 结果 对照组和观察组总有效率分别为71.88%和93.75%，观察组的总有效率显著高于对照组，差异具有统计学意义（P<0.05）。治疗前两组气促指数、肺功能FEV1差异无统计学意义（P>0.05），治疗后两组气促指数均较治疗前有所下降，肺功能FEV1较治疗前有所上升，且观察组气促指数显著低于对照组，差异具有统计学意义（P<0.05），肺功能FEV1显著高于对照组，差异具有统计学意义（P<0.05）。治疗前两组气道直径、气道横截面积差异无统计学意义（P>0.05），治疗后两组气道直径、气道横截面积均较治疗前有所上升，且观察组气道直径、气道横截面积显著高于对照组，差异具有统计学意义（P<0.05）。治疗前两组生活质量评分差异无统计学意义（P>0.05），治疗后两组生活质量评分均较治疗前有所上升，且观察组生活质量评分显著高于对照组，差异具有统计学意义（P<0.05）。 结论 经电子支气管镜氩等离子体凝固联合高频电刀治疗气道狹窄效果良好，可有效缓解患者气促及呼吸困难等临床症状，提高肺功能，提高生活质量。

[关键词] 电子支气管镜;氩等离子体凝固;气道狭窄;高频电刀;临床价值

[中图分类号] R730.5          [文献标识码] A          [文章编号] 1673-9701（2019）09-0016-05

[Abstract] Objective To investigate the clinical value of argon plasma coagulation（APC） via electronic bronchoscope combined with high-frequency electrotome in the treatment of airway stenosis. Methods 64 patients with malignant tracheal and bronchial stenosis who were admitted to our hospital from June 2015 to June 2017 were selected as the study subjects. All patients were divided into control group and observation group by random number table method， with 32 cases in each group. Patients in the control group were given high-frequency electrotome. Patients in the observation group were given APC+high-frequency electrotome. The clinical efficacy was compared between the two groups. At the same time， the dyspnea index， pulmonary function FEV1， airway diameter， airway cross-sectional area and quality of life score were compared before and after treatment in both groups. Results The total effective rate in the control group and the observation group were 71.88% and 93.75%， respectively. The total effective rate in the observation group was significantly higher than that in the control group， and the difference was statistically significant（P<0.05）. There was no statistically significant difference in the dyspnea index and FEV1 between the two groups before treatment（P>0.05）. After treatment， the dyspnea index of both groups was decreased compared with that before treatment， and the pulmonary function FEV1 was increased compared with that before treatment. The dyspnea index in the observation group was significantly lower than that in the control group， and the difference was statistically significant（P<0.05）. The pulmonary function FEV1 was significantly higher than that in the control group， and the difference was statistically significant（P<0.05）. There was no statistically significant difference in airway diameter and airway cross-sectional area between the two groups before treatment（P>0.05）. After treatment， the airway diameter and airway cross-sectional area in the two groups were increased compared with that before treatment. The airway diameter and airway cross-sectional area in the observation group were significantly higher than those in the control group， and the difference was statistically significant（P<0.05）. There was no statistically significant difference in the quality of life score between the two groups before treatment（P>0.05）. After treatment， the quality of life scores in the two groups were increased compared with those before treatment. The quality of life scores in the observation group was significantly higher than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion The argon plasma coagulation via electronic bronchoscope combined with high-frequency electrotome in the treatment of airway stenosis has a favorable effect， which can effectively alleviate clinical symptoms such as shortness of breath and dyspnea， improve lung function and improve quality of life.