Clinical Study Of Argon Plasma Coagulation Combined With Cryotherapy Under Bronchoscope In The Treatment Of Airway Stenosis Caused By Lung Cancer

Objective To investigate the clinical characteristics of airway stenosis caused by lung cancer and the efficacy and safety of argon plasma coagulation combined with cryosurgery under bronchoscopy.Methods 104 patients with lung cancer who received argon plasma coagulation or argon plasma coagulation combined with cryotherapy in the inpatient department of respiratory and critical medicine of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2019 to December 2021 were analyzed retrospectively.Analyze the general situation of the selected patients,and according to different treatment methods,they were divided into the control group treated with argon plasma coagulation and the observation group treated with argon plasma coagulation combined with cryotherapy.By comparing the shortness of breath score,Karnofsky performance score,the degree and curative effect of airway stenosis between the two groups before and after treatment,the intraoperative and postoperative complications were recorded to evaluate the safety of the operation.Results Among the 104 patients in this study,there were 81 male patients and 23 female patients,with an average age of 61.24±9.33,Squamous cell carcinoma accounted for the highest proportion in this study（55%）,more than half of the patients had severe airway stenosis（64%）,shortness of breath（87%）was the most common symptom in this study,52% of the patients were complicated with obstructive pneumonia,and 33%of patients had tumors in the central airway.After treatment,the shortness of breath score in the control group decreased from 2.88±1.04 to 1.40±0.63,and that in the observation group decreased from 3.10±1.07 to 1.02±0.67.There was significant difference in the score of shortness of breath after treatment compared with that before treatment（P<0.05）.The KPS of the control group was from 75.58±9.59 to87.12±7.23,and that of the observation group was from 73.46±6.53 to 92.69±5.28.There was significant difference in KPS after treatment compared with that before treatment（P<0.05）.After treatment,The reduction degree of shortness of breath score and the increase degree of KPS in the observation group was significantly higher than that in the control group（P<0.05）.There was no significant difference in the degree of airway stenosis between the two groups before treatment（P>0.05）.After treatment,there were 33 cases of mild stenosis,14 cases of moderate stenosis and 5 cases of severe stenosis in the control group,while 45 cases of mild stenosis,6cases of moderate stenosis and 1 case of severe stenosis in the observation group.The degree of airway stenosis in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）.After treatment,the control group was completely effective,partially effective and slightly effective in 26 cases,18 cases and 8 cases respectively,and the effective rate was85%,while 38 cases were completely effective,10 cases were partially effective and4 cases were slightly effective in the observation group,with the effective rate of92%.The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant（P<0.05）.The degree of bleeding in the control group was higher than that in the observation group,the difference was statistically significant（P<0.05）.Conclusion Male patients with airway stenosis caused by lung cancer are more than female patients,mainly the elderly.Squamous cell carcinoma is the most common,which often occurs in the central airway,mostly severe stenosis.Shortness of breath is the most common clinical manifestation,often accompanied by obstructive pneumonia.Bronchoscopic argon plasma coagulation combined with cryotherapy is more effective than argon plasma coagulation alone in the treatment of airway stenosis caused by lung cancer.It is a very safe operation.