氩等离子体凝固术对支气管内恶性肿瘤引起的咯血患者的有效性和安全性。

IF 3.5 3区 医学 Q2 RESPIRATORY SYSTEM Respiration Pub Date : 2024-01-01 Epub Date: 2024-06-10 DOI:10.1159/000539725
Michele Mondoni, Andrea Baccelli, Momen M Wahidi, Luca Alessandro Belmonte, Laura Saderi, Paolo Carlucci, Fausta Alfano, Rocco Francesco Rinaldo, Gabriele Guido, Carmelo Intravaia, Andrea Luciani, Paolo Busatto, Stefano Centanni, Giovanni Sotgiu
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引用次数: 0

摘要

背景:中心性肿瘤和咯血患者的存活率很低。支气管镜介入治疗后 48 小时症状控制且无复发,可改善这些患者的预后。支气管镜氩等离子凝固术(APC)是治疗中心性恶性肿瘤患者咯血的有效技术。然而,有关其有效性和安全性的文献数据有限,而且成功的主要预测因素仍不明确:开展了一项观察性、前瞻性、单中心队列研究,以评估支气管镜 APC 治疗支气管内恶性肿瘤引起的咯血患者的疗效(即在随后 48 小时内立即止血且不复发)以及成功的主要预测因素:共有 76 名患者入选,中位年龄为 75 岁(IQR:65-79)。67名(88.2%)患者在支气管镜下进行 APC 治疗 48 小时后出血停止且未复发。非严重不良事件发生率较低(5.3%),术后 3.5 个月的咯血复发率也较低(7.6%)。没有发现任何临床、人口统计学和内窥镜变量与 48 小时后的成功手术有关:这项研究表明,无论患者的临床特征、肿瘤的内镜和组织学特征以及症状的严重程度如何,支气管镜 APC 都是治疗支气管内恶性肿瘤引起的咯血患者的有效方法。此外,该疗法的并发症发生率低,而且在控制出血方面具有长期疗效。
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Effectiveness and Safety of Argon Plasma Coagulation in Patients with Haemoptysis Caused by an Endobronchial Malignancy.

Introduction: Patients with central neoplasms and haemoptysis show low survival rates. Symptom control without recurrence 48 h after bronchoscopic interventions may improve the prognosis of these patients. Bronchoscopic argon plasma coagulation (APC) is a useful technique for endobronchial management of haemoptysis in patients with central malignancies. Nevertheless, limited data are available in the literature on its efficacy and safety and the main predictors of success are still unclear.

Methods: An observational, prospective, single-centre cohort study was carried out to assess the efficacy (i.e., immediate bleeding cessation without recurrence during the following 48 h) of bronchoscopic APC in the treatment of patients with haemoptysis caused by endobronchial malignancies and the main predictors of success.

Results: A total of 76 patients with median age 75 years (interquartile range: 65-79) were enrolled. 67 (88.2%) patients had bleeding cessation without recurrence 48 h after bronchoscopic APC. A low rate of non-serious adverse events (5.3%) was recorded and a low (7.6%) recurrence rate of haemoptysis at 3.5 months after the procedure was also shown. No clinical, demographic and endoscopic variables related to a successful procedure at 48 h were found.

Conclusion: This study demonstrates that bronchoscopic APC is an effective procedure in the treatment of patients with haemoptysis caused by endobronchial malignancies, regardless of the clinical characteristics of the patients, the endoscopic and histological features of the neoplasm and the severity of the symptom. Furthermore, it shows a low rate of complications and long-term efficacy in bleeding control.

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来源期刊
Respiration
Respiration 医学-呼吸系统
CiteScore
7.30
自引率
5.40%
发文量
82
审稿时长
4-8 weeks
期刊介绍: ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.
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