气管支架置入术治疗肿瘤引起的急性气道狭窄

背景与目的:肿瘤引起的急性气道狭窄,情况危急,对于此类患者实行金属气管支架置入术,有助解除患者呼吸困难,为进一步治疗争取时间。本研究旨在探讨其临床应用效果及并发症处理。方法:52例由肿瘤引起的急性气道狭窄患者在纤维支气管镜引导下,置入镍钛合金(Ni-Ti)支架。结果:52例患者支架放置成功,患者呼吸困难明显改善,术前PaO2、PaCO2、KPS值分别为(7.74±0.99)kPa、(5.37±0.39)kPa、68.85±8.08,术后PaO2、PaCO2、KPS值分别为(11.12±0.61)kPa、(4.58±0.30)kPa、84.62±5.03(P<0.01);术后并发症经对症处理后,均取得较好的疗效。结论:气管支架置入术对于肿瘤局部压迫、侵犯大气道而引起的急性呼吸困难是一种较好的姑息性治疗手段,可以挽救患者的生命,提高晚期肿瘤患者生活质量,为肿瘤患者进一步治疗创造机会。

Tracheal stent implantation for the treatment of tumor-induced acute airway stenosis

BACKGROUND & OBJECTIVE: Tumor-induced acute airway stenosis is a medical emergency. Metal airway stent implantation can relieve dyspnea of patients suffering from this symptom and provide time for their further treatment. This study was to investigate the clinical application, efficacy, and complication management of tracheal stent implantation for the treatment of tumor-induced acute airway stenosis. METHODS: Nickel-titanium (Ni-Ti) alloy stent implantation was performed under the guidance of fiber-optic bronchoscopy in 52 patients with tumor-induced acute airway stenosis. RESULTS: Stent implantation was successful in all 52 patients. Dyspnea in all patients was significantly relieved. Values of arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and Karnofsky performance status (KPS) changed from (7.74+/-0.99) kPa, (5.37+/-0.39) kPa, and (68.85+/-8.08) preoperatively to (11.12+/-0.61) kPa, (4.58+/-0.30) kPa, and (84.62+/-5.03) postoperatively (P<0.01). The three-year survival rate was higher in lymphoma group than in lung cancer or esophageal cancer group. Postoperative complications were properly managed in all cases after symptomatic treatments. CONCLUSIONS: Tracheal stent implantation is an effective palliative treatment for acute dyspnea caused by local tumor compression or tumor invasion of large airways. It can rescue patients at risk for airway obstruction, improve the quality of life in terminal cancer patients, and provide further treatment opportunities for them.