呼吸系统疾病的非血管介入治疗

Non-vascular interventional therapy for respiratory diseases

复习近年文献中有关呼吸系统疾病非血管介入治疗的技术和方法。气道内金属支架植入可以迅速解除患者的气道阻塞、改善呼吸,由于植入后再狭窄的发生率较高,因此,对于良性疾病是否采用金属支架植入疗法仍持慎重态度。与传统的肺减容术相比,经支气管镜肺减容术是一种有效、安全、微创的治疗方法,其临床应用有待于进一步研究。经支气管镜介入治疗支气管瘘,为该类患者提供了除外科手术以外的有效治疗手段。B超或CT引导下经皮肺穿刺技术已经逐步应用于肺部一些良、恶性疾病的治疗,取得了一定的疗效。

To review the recent literature relating to non-vascular interventional therapy of respiratory diseases. Metal airway stent insertion can immediately relieve tracheobronchial obstruction and improve pulmonary function. However, as there is a high occurrence of the restenosis after stent insertion, it should be very careful to use metal stenting to treat the benign airway obstruction. Compared with traditional lung volume reduction surgery in treating severe emphysema, bronchoscopic lung volume reduction appears to be effective, safe and less invasive, although its clinical usefullness need to be further proved. Endoscopic occlusion of bronchial fistula represents an effective alternative to surgical treatment. Percutaneous lung biopsy under ultrasound or CT guidance has been applied successfully in the management of both benign and malignant lesions.