经电子支气管镜放置支架治疗气道狭窄及气管食管瘘30例分析

Endoscopic airway stenting for tracheobronchial stenosis and tracheoesophageal fistula

目的探讨电子支气管镜直视下放置镍钛合金支架对气管、支气管狭窄及气管食管瘘的治疗效果及不良反应。方法对30例不同原因引起的气管、主支气管狭窄及气管食道瘘患者在气管镜直视下行气道镍钛记忆合金支架置入,观察支架置入前后患者症状、血气分析变化及相关并发症。结果所有患者术后呼吸困难均立即明显缓解,8例合并气管食管瘘患者在置入带膜气管支架后进食呛咳消失,动脉血氧分压升高。术后1个月肉芽组织增生2例,随访6个月1例患者支架断裂。结论电子支气管镜直视下置入镍钛合金支架是治疗气道狭窄及气管食管瘘安全、有效的方法。

Objective To evaluate the therapeutic efficacy and complications of endoscopic placement of nickel-titanium alloy stents for the treatment of airway stenosis and tracheoesophageal fistula.Methods Nickel titanium alloy stents were placed into the airway of 21 patients with tracheobronchial stenosis under direct view of bronchoscope.The symptoms of the patients,the change in the blood gas analysis and the complications before and after the trachel stent implantation were observed.Results Dyspnea was relived in all of patients immmediately after stenting and dilatation.Disappearance of cough during food taking was found in 8 patients with tracheoesophageal fistula after placement of coated stent,arterial partial pressure of oxygen was increased in all 30 patients.Granuloma occurred in 2 patients in 1 month after senting,stent breakage in 1 patients in 6 month after senting.Conclusion Endoscopic placement of nickel-titanium alloy stents is a safe and useful measure for the treatment of airway stenosis and tracheoesophageal fistula.