气管镜治疗187例次因恶性肿瘤引起的阻塞性肺不张的临床分析

BACKGROUND AND OBJECTIVE: Obstructive atelectasis is frequently accompanied by pulmonary infection and hypoxia. The key to treating this condition is by directly reopening the obstructive airway. The aim of the present study is to explore the safety and efficacy of interventional bronchoscopy for the treatment of malignant obstructive atelectasis. METHODS: A total of 120 cases with pathology-proved malignant obstructive atelectasis were retrospectively analyzed for the treatment of argon plasma coagulation and cryosurgery under bronchoscopy. Patients' age is between 5 and 90 years old. RESULTS: A total of 120 cases had 187 atelectasis originating from 98 lesions with primary airway tumors and 89 with metastases. The most common location of atelectasis was in the upper lobe in the primary group and in the single lung in the metastasis group. Although there was no significant difference in tumor debulging between the two groups, the reopening rate of atelectasis was lower in the primary group than that in the metastasis group. The Karnofsky physical score significantly increased, and shortbreath scale decreased after interventional bronchoscopy. Among the patients, 3/4 had hypoxemia and 3.4% had severe bleeding, which caused the death of 1 patient during a procedure. The mean survival time was 6 months, and the survival rate of 1 year was 27.1%. CONCLUSIONS: Bronchoscopy can rapidly and effectively debulge the airway tumor and reopen the atelectasis.