经可曲性支气管镜置入支架治疗恶性中心气道狭窄的临床研究(附33例报告)

目的　观察经可曲性支气管镜置入支架治疗恶性中心气道狭窄的临床疗效和安全性。方法　 33例患者置入国产镍钛记忆合金支架 ,支架通过X线透视定位或支气管镜直视下定位释放。结果　 33例患者共置入 4 2枚支架 ,均一次性成功。支架置入后狭窄管腔均明显扩大 ,气急均减轻 ,气促指数、Karnofsky评分与置入前比较有显著性差异 (P <0 0 1)。主要并发症有支架上分泌物附着、支架内肿瘤生长、刺激性咳嗽、反复气道感染。结论　经可曲性支气管镜置入支架治疗无手术指征的恶性中心气道狭窄操作简便安全、短期效果肯定 ,值得临床推广。

Implantation of nitinol stents in malignant airway stenosis by flexible bronchoscopy

Objective To evaluate the efficacy and safety of implanting nitinol stents in malignant airway stenosis by flexible bronchoscopy.Methods Domestic stents were used on 33 patients with malignant airway sterosis.During the procedure,the release of the stents was either under fluoroscopic guidance or under direct visual monitoring through ultrathin bronchoscope.Results Forty-two stents were inserted,and all of the interventions were successful.Immediate relief of dyspnea was achieved in all the patients.Both dyspnea index and Karnofsky score improved significantly after implantation(P<0.01).The main complications were mucus retention,tumor ingrowth,cough,and tracheobronchial infection.Conclusion Implatation of nitinol stents can improve quality of life for patients with inoperable malignant central airway stenosis,and the stents can be inserted safely by flexible bronchoscopy.