大气道狭窄的支架治疗

目的　探讨支架植入术在治疗大气道狭窄中的相关技术问题。方法　回顾性分析 19例大气道支架植入术 ,结合文献复习讨论各种大气道支架的优缺点及其选择 ;术中的麻醉支持和指征监测对患者安全的意义 ;支架术的并发症及其预防。结果　在静脉麻醉和黏膜表面麻醉的支持下 ,19个Wallstent成功缓解了共 19处气管、主支气管、中间支气管狭窄。包括肿瘤性 15例、结核性 3例、气管软化 1例。静脉麻醉支持和生命指征监测使气道支架术过程更安全、操作更精细。Wallstent和Ultraflex是目前气道支架比较理想的选择。正确选择支架、术中精确定位、术后必要的抗炎抗感染和镇咳治疗降低了并发症的发生率。结论　支架植入术是大气道狭窄的可靠治疗方法 ,术中静脉麻醉支持和生命指征监测具有重要意义。

Stenting of major airway constriction

Objective To investigate the correlated issues in the stenting treatment of major airway constriction. Methods Nineteen cases of major airway stenting procedure were studied retrospectively. The clinical choice of stents of different advantages or deficiencies were discussed. The importances of intravenous anesthesia supporting, life parameters monitoring during the procedures and the prevention of complications were analysed. Results Under intravenous and local anesthesia, 19 Wallstents had been successively placed and relieved 19 cases of major airway constrictions due to malignant or benign diseases (15 of tumors, 3 of tuberculosis, 1 of tracheomalacia). Intravenous anesthesia and life parameters monitoring had made the procedures more safe and precise. Conclusions Major airway stenting is an reliable method for relieving trachiobronchial stenosis; and intravenous anesthesia supporting and life parameters monitoring guarantee the satisfactions of procedures.