气管支架置入联合放疗治疗癌性气管狭窄13例疗效观察

Clinical observation of tracheal stent placement combined with radiotherapy on airway stenosis of 13 cancer cases

目的:探讨气管内支架置入联合放疗治疗癌性气管狭窄的临床疗效。方法:选择2008年01月-2011年03月我院收治的13例支气管狭窄患者,在X线透视下应用介入治疗放置镍钛合金支架。随后对其进行三维适形放射治疗,观察患者呼吸困难改善情况及近期疗效。结果:13例患者均成功置入支架。术后患者通气功能迅速改善,气促分级从3.7±0.6下降至1.5±0.4。动脉血气PaO2从50.8±5.2升至82.7±6.5,PaCO2从60.2±7.3降至41.5±5.1,血氧饱和度从术前(80.4±6.4)%升至术后(95.6±4.2)%。放疗后肿块较前明显退缩,随访12个月,生存率达76.9%,无显著并发症发生。结论:气管内支架置入联合放疗可迅速改善患者通气功能,改善生活质量,提高生存率。

Objective：To evaluate the clinical effects of tracheal stent implantation and radiotherapy on malig- nant airway stenosis cases. Methods ：Thirteen patients were selected and treated with combined metal stent place- ment under X - ray and 3 D - CRT. Results：In 13 cases,metallic stents were placed successfully and ventilation func- tion were relieved immediately. Shortness of breath grading and PaCO2 decreased from 3.7 ±0.6,60.2 ±7.3 to 1.5 ±0.4,41.5 ± 5.1 after intervention, while PaO2 and oxygen saturation increased from 50.8 ± 5.2, （ 80.4± 6.4 ） % to 82.7 ± 6.5, （ 95.6 ± 4.2 ） % after stent implantation. The mass was significantly reduced after radiotherapy. Follow up 12 months,there were no severe complications and the survival rate was 76.9%. Conclusion：The tracheal stent im- plantation combined with radiotherapy could relieve ventilation function quickly, improve the quality of life and the survival rate.