摘要
目的探讨在局麻和数字减影血管造影机（DSA）监视下应用“双管法”置入镍钛记忆合金支架急诊治疗气管良恶性狭窄和气管瘘的疗效。方法回顾性分析2003—2011年间，在DSA监视和咽喉、气管局麻下，先经鼻或气管瘘口留置通气导管，予以2-4L／min流量供氧，再经气管置入不同类型镍钛记忆合金气管支架的25个典型病例。结果25例患者行镍钛记忆合金支架均成功，共置入一体式倒Y型支架2枚，“子弹头”覆膜支架1枚，管状覆膜支架5枚，管状裸支架20枚。所有患者术后呼吸困难明显改善，气促评级由Ⅲ-Ⅳ级改善为0-I级，氧饱和度（SP02）由高流量吸氧时的（73．24±3．07）％提高至自然呼吸时的（92．55±3．08）％，差异有统计学意义（P〈0．05）。结论在局麻和DSA下，采用“双管法”置入镍钛记忆合金气管支架，是一种安全，有效的治疗方法，操作简单，具有一定的临床应用价值。
Objective To assess the efficacy of ＂double-barreled＂ nickel-titanium memory alloy stent placement for treatment of benign or malignant tracheal stenosis and tracheal fistula under local anesthesia and digital subtraction angiography （DSA） monitoring. Methods A retrospective analysis was performed on the profiles of 25 typical cases who received intubation via the nasal cavity or tracheal fistula （02：2-4 L/min） followed by endotracheal placement of various nickel-titanium memory alloy stents under DSA monitoring and laryngopharyngeal or tracheal local anesthesia between 2003 and 2011. Results Nickel-titanium stents, including 2 integrated inverted Y-shaped stents, a bullet-like membrane-coated stent, 5 tubular membrane-coated stents and 20 tubular common stents, were successfully implanted in 25 patients. Stent placement was associated with marked improvement in dyspnea, and the grading reduced from Ⅲ-Ⅳ to 0- I . Furthermore, pulse oxygen saturation （SPO2） was improved to （92.55^-3.08）% during spontaneous breathing as compared with （73.24-3.07）% previously during high-flow oxygen therapy （P〈 0.05）. Conclusion The ＂double- barreled＂ nickel- titanium memory alloy stent placement under local anesthesia and DSA monitoring is worthwhile for clinical application due to its safety, effectiveness and simplicity.
出处
《中华生物医学工程杂志》
CAS
2012年第4期288-291,共4页
Chinese Journal of Biomedical Engineering
关键词
气管狭窄
气管瘘
支架
介入性
放射学
Tracheal stenosis
Tracheal fistula
Stent
Interventional
Radiology
