良性器质性气管狭窄患者的气管支架置入术

Self-expanding metallic stents for treatment of benign tracheobronchial stenosis

目的 观察气管支架置入术治疗良性器质性气管狭窄的疗效。方法 对 19例因良性病变引起气管狭窄的患者置入钛金属自膨胀网状气管专用支架后定期随访 10～ 18个月。结果 全部患者均顺利置入支架 ,呼吸困难症状明显改善 ,术前气促评级为 2级的 7例患者 ,支架置入后 5例为 0级 ,2例为 1级 ;术前为 3级的 6例 ,术后 3例为 0级 ,3例为 1级 ;术前为 4级的 6例 ,术后 1例为 1级 ,4例为 2级 ,1例为 3级。血气分析正常 ,肺功能测验指标明显改善 ,阻塞性肺炎治愈。经 10～ 18个月随访 ,出现反复肺炎 3例 ,支架网眼内肉芽增生形成阻塞 2例 ,支架出现移位 1例 ,经处理后均保持通畅。结论 钛金属网状气管支架对良性器质性气管狭窄有良好的治疗作用 ,预防感染。

Objective To report the use of self expanding metallic stents in treatment of benign tracheobronchial stenosis. Methods Nineteen patients with benign tracheobronchial stenosis were treated with implantation of self expanding stents (Ultraflex, Microvasive). Results Stents produced immediate improvement in clinical pulmonary sign and symptoms. Pulmonary function tests in 10 patients demonstrated a mean improvement in FEV1of 45%, FVC of 38%. Following up duration ranged from 10-18 months. Complications included recurrent pneumonia in 3 patients, airway obstruction due to granuloma formation in 2 patients, and stent migration in 1 patient. They were treated successfully with antibiotic therapy, laser therapy, and stent reimplantation, respectively. Conclusion Self expanding metallic stent implantation is a feasible and effective method of treating benign tracheobronchial stenosis.