支气管镜介入治疗联合局部应用紫杉醇治疗良性气道瘢痕狭窄的临床研究

Effect of bronchoscopic interventional therapy combined with local application of topical application with Paclitaxel in the study of benign cicatricial airway stenosis

摘要:

 

摘要：目的  研究支气管镜介入治疗联合局部注射紫杉醇治疗良性气道瘢痕狭窄的疗效及安全性。 方法  32例良性气道瘢痕狭窄患者，将其分为紫杉醇组、丝裂霉素组和对照组。其中，紫杉醇组8例，丝裂霉素组12例，对照组12例，紫杉醇组和丝裂霉素组采用气管镜下介入治疗，包括球囊扩张术、电刀切除和冷冻等，并在气道狭窄部位局部注射紫杉醇或丝裂霉素，对照组仅采用常规气管镜下介入治疗。随访时间为6个月，测量治疗前后气道狭窄部位的横截面积和气道直径，治疗前后呼吸困难指数，观察气道狭窄部位局部应用紫杉醇、丝裂霉素的疗效及安全性。结果  治疗前后气道狭窄部位横截面积及直径比较结果表明紫杉醇组和丝裂霉素组的疗效较对照组疗效好，3组患者治疗前后气道横截面积及直径差异有统计学意义（P <0.05），紫杉醇组与丝裂霉素组疗效相比差异无统计学意义（P >0.05），3组患者治疗前后呼吸困难指数的改善差异有统计学意义（P < 0.05），紫杉醇组、丝裂霉素组6个月内再次行介入治疗次数有一定减少，但差异无统计学意义（P >0.05）。紫杉醇组、丝裂霉素组患者在观察期内均未出现与药物相关的并发症。结论  气道狭窄部位局部应用紫杉醇可抑制瘢痕性气道狭窄，且较常规介入治疗法明显延长良性瘢痕增生性气道狭窄再狭窄的时间，疗效及安全性均较好。

Abstract:

  Abstract: Objective To assess the efficacy and safety of bronchoscope interventional therapy combined with local injection of Paclitaxel in the treatment of benign airway stenosis scar. Methods 32 cases of benign airway stenosis scar will be divided into groups of Paclitaxel, Mitomycin group and the control group, eight cases in which the Paclitaxel group, Mitomycin group of 12 patients in the control group of 12 patients, Paclitaxel and Mitomycin prime group with tracheal endoscopic intervention, including balloon angioplasty, electrical excision, freezing, and airway stenosis local injection of Paclitaxel or Mitomycin, the control group using conventional bronchoscope intervention. Follow-up of six months, measured before and after treatment of cross-sectional area, calculated airway stenosis airway diameter, dyspnea index before and after treatment were observed airway stenosis local application of Paclitaxel, Mitomycin efficacy and safety. Results Before and after the treatment of airway cross-sectional area and diameter stenosis comparison shows that Paclitaxel group, efficacy of Mitomycin group than in the control group the efficacy of airway cross-sectional area and diameter differences before and after the three groups of patients was statistically significant (P < 0.05), Paclitaxel group compared with the efficacy of Mitomycin group showed no significant difference (P > 0.05), to improve the three groups of patients before and after treatment difference dyspnea index was statistically significant (P < 0.05), Paclitaxel, silk Mitomycin group within six months again interventional treatment also significantly reduced the number of times, the difference was not statistically significant (P > 0.05). Paclitaxel group, MMC group were no drug-related complications occur during the observation period. Conclusion Partial airway stenosis Paclitaxel inhibits airway scarring, and less conventional way interventional therapy significantly prolonged benign airway stenosis scar restenosis time, efficacy and safety are good.