摘要
目的:评价Y形自膨式气道覆膜支架治疗食管癌切除术后胸腔胃-右主支气管瘘的疗效。方法:收集接受Y形自膨式气道覆膜支架治疗的35例胸腔胃-右主支气管瘘患者的临床资料,支架置入前和置入2周后采用MRC、KPS及PSQI量表评估患者呼吸困难程度、肿瘤患者功能状态等级和睡眠质量,并记录支架置入术后18个月内支架相关并发症发生情况及患者存活状况。结果:35例患者共置入67枚气道覆膜支架,管状支架1枚,大Y形支架34枚,小Y形支架32枚。1枚置入失败,技术成功率为98.5%(66/67)。支架置入前患者MRC、KPS、PSQI评分分别为(3.60±0.77)、(34.86±11.47)、(16.90±1.37),术后2周分别为(1.57±0.78)、(57.14±12.96)、(10.03±2.70),均较术前改善(P<0.001)。9(25.7%)例发生主要并发症,11(31.4%)例发生一般并发症,无大出血、气道破裂等致死性并发症发生。支架取出10(28.6%)例。支架置入术后1、6、18个月存活率分别为74.3%、34.3%、11.4%。结论:Y形自膨式气道覆膜支架可有效封堵瘘口,改善胸腔胃-右主支气管瘘患者的存活状态。
Aim:To evaluate the safety and clinical efficacy of Y-type airway covered self-expandable metal stent(SEMS)for the treatment of thoracogastric-right main bronchial fistula after esophagectomy.Methods:Clinical data of 35 patients treated with Y-type air covered SEMS placement for thoracogastric-right main bronchial fistulas were collected.MRC,KPS and PSQI were used to assess the degree of dyspnea,functional status of patients with tumors and sleep quality before and 2 weeks after stent implantation.The incidence of stent-related complications and survival status within 18 months after stent implantation were recorded.Results:A total of 67 airway covered stents were placed in 35 patients,including 1 tubular stent,34 large Y-type stents and 32 small Y-type stents.Only one stent failed in placement,and technical success rate was up to 98.5%(66/67).The scores of MRC,KPS,PSQI before stent placement were(3.60±0.77),(34.86±11.47),(16.90±1.37),and 2 weeks after were(1.57±0.78),(57.14±12.96),(10.03±2.70),respectively,and the sores after stent placement were all improved compared with those before stent placement(P<0.001).Major complications occurred in 9(25.7%)patients,and 11(31.4%)patients with general complications,and there were no fatal complications of massive hemorrhage or airway perforation.Stents removal applied with 10(28.6%)patients.The survival rates of 1st,6th and 18th month after the surgery were 74.3%,34.3%and 11.4%,respectively.Conclusion:Y-type airway covered SEMS can effectively seal the fistula and improve the survival status of patients with thoracogastric-right main bronchial fistula.
作者
牛荣仿
韩新巍
吴刚
焦德超
毕永华
路慧彬
任克伟
尉泽鹏
许琳慧
陈建建
NIU Rongfang;HAN Xinwei;WU Gang;JIAO Dechao;BI Yonghua;LU Huibin;REN Kewei;YU Zepeng;XU Linhui;CHEN Jianjian(Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2019年第5期667-671,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
国家高新技术研究发展计划(863计划)项目(2015AA020301)
关键词
Y形自膨式金属支架
气道覆膜支架
胸腔胃-右主支气管瘘
Y-type self-expandable metal stent
airway covered stent
thoracogastric-right main bronchial fistula
