摘要
纳入16例气管隆突处气道狭窄患者,其中良性病变4例,恶性病变12例。对气道内病变先用氩等离子体凝固清除,随后放置气道分叉型金属支架。所选支架均为国产Z型不锈钢被膜支架。L型及I型支架均在软质气管镜引导下放置,Y型支架在气管镜和透视结合下放置。氩等离子体凝固治疗前气管、左、右主支气管的阻塞程度分别为(58.8±9.1)%,(67.4±7.4)%及(69.6±8.9)%,氩等离子体凝固首次消融后的阻塞程度分别为(7.5±2.4)%,(19.4±4.1)%及(27.6±5.4)%。所有患者胸闷、气憋症状均有明显改善,气促指数降低,体能状况Karnofsky评分增高。12例患者一次成功放置支架,其中9例为Y型;4例放置失败,其中2例肺癌患者隆突较宽,Y型支架难以置入,改用L型+I型。患者中位生存时间为10个月,平均生存时间为13个月。结果提示,氩等离子体凝固结合分叉型被膜金属支架置入治疗气管隆突处狭窄可以改善患者梗阻症状,提高生活质量。
A total of 16 patients with airway stenosis including benign lesion （n=4） and malignant disease （n=12） were treated with argon plasma coagulation （APC） and Z-type covered retrievable metallic stent. L- and 1-type stents were placed by guidance of bronchoscope, while Y-type stent was placed by the guidance of both bronchoscope and fluoroscope. Airway stenosis was from （58.8 ±9.1）% before APC to （7.5±2.4）% after APC in tracheal, from （67.4 ±7.4）% to （19.4±4.1）% in left main bronchus, from （69.6±8.9）% to （27.6±5.4）% in right main bronchus. Symptoms of chest distress and breathlessness were improved remarkably, tachypnea indexes were decreased, but Karnofsky performance scope were increased. Twelve stents were successfully installed by the first time, including 9 Y-shape; otherwise, 4 stents failed to be installed because the carinal was too wide to insert the Y-shape stent in two patients with lung cancer; finally, L ＋ I type stents were used. Median survival time after successful stenting was 10 months, and mean time was 13 months. APC combined with bifurcated metal stents relieved obstruction and improved quality of life.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第30期5995-6000,共6页
Journal of Clinical Rehabilitative Tissue Engineering Research
