局麻下金属自膨支架治疗气管狭窄15例临床分析

Efficacy of self-expandable metallic stents in the treatment of tracheal stenosis

目的评价局麻及透视下植入金属自膨支架治疗气管狭窄的安全性与疗效。方法我院2009年5月～2013年2月共收治了15例有吸气性呼吸困难的气管狭窄患者，经口腔喉部1％地卡因溶液喷雾麻醉后，于透视下用导丝引导5F导管进入气管后经导管注入1％利多卡因溶液5～10ml，再于透视定位下送人并释放金属自膨支架。结果15例患者气管支架均释放成功，呼吸困难立即明显改善，无出血等严重并发症。结论局麻及透视下植入金属自膨支架是一种安全、有效的治疗气管狭窄合并吸气性呼吸困难的方法，能迅速改善呼吸困难等症状，提高患者生活质量，为患者进一步治疗创造机会，具有较高的临床实用价值。

Objective To assess the efficacy of fluoroscopy-guided insertion of self-expandable metallic stents under local anesthesia in the treatment of tracheal stenosis. Methods From May 2009 to February 2013, 15 patients with dyspnea from tracheal stenosis were treated under local anesthesia. After 1% tetracaine throat spray, a 5F catheter was introduced into the trachea under fluoroscopy with a guide wire. 5-10 ml of 1% lidocaine solution was injected into the trachea via the catheter for additional local anesthesia. The self-expandable metallic stent was then implanted in the stenotic segment. Results The stents were successfully implanted in all 15 patients with immediate relief of the dyspnea. No major complications such as hemorrhage occurred. Conclusions The implantation of self-expandable metallic stents under fluoroscopy and local anesthesia is safe and effective for the treatment of symptomatic tracheal stenosis. This procedure can be applied in the outpatient clinics.