气管支架治疗气管支气管良恶性狭窄疗效分析

To Evaluation the Therapy of Tracheal Stent Implanted in Tracheobronchial Benign and Malignant Stenosis

目的：探讨气管支架植入治疗气管支气管良恶性狭窄的疗效,并发症发生的原因及防治方法。材料与方法：156例气管支气管狭窄患者,气管肿瘤致狭窄29例,肺癌致狭窄33例,食管癌及食管癌纵隔淋巴结转移致狭窄69例,纵隔肿瘤致狭窄12例,其它原因致狭窄13例,行气管支架植入术。结果：156例患者行气管支架植入术,均1次植入成功。患者呼吸困难、喘鸣及窒息症状立即改善,气道通畅。出现胸部异物感及胸痛73（46.8%）例;肺部感染23（14.7%）例;呼吸、心跳骤停2（1.3%）例;咯血19（12.1%）例;再狭窄15（9.6%）例;支架移位10（6.4%）例;气管软化3（1.9%）例;气管瘘4（2.6%）例;声音嘶哑等喉返神经损伤表现5（3.2%）例。37例于手术后6~60月死亡,现生存的83例均呼吸通畅,未发生痰液等阻塞气管情况。结论：介入治疗各种良恶性病变引起的气管支气管狭窄是一种简单、安全、有效的治疗方法,能明显提高患者的生活质量。

Purpose： To evaluate the therapy of tracheal stent in tracheobronchial benign and malignant stenosis, causes and prevention measures of the complications occurred. Materials and Methods： 156 cases were implanted with tra- cheal stent. There were 29 ceses of tracheal tumour lead to stenosis, 33ceses of lung cancer, 69 cases of esophageal carcino- ma or mediastinal lymph node metastasis encroaching, 12ceses of mediastinal tumour and 13 cases of others caused. Results： All stents were implanted successfully once, The symptoms of dyspnea, stridor and choke were immediately relieved after fin- ishing the stent placement procedure, the tracheal smoothly. 73 （46. 8% ）cases Patient had chest of foreign body sensation and pain in the chest ; 23 （14.7%）cases had pulmonary infection; 2 （1.3%） cases had breathe-cardiac arrest; 19 （12. 1% ）cases had hemoptysis; 15 （9. 6% ） cases had restenosis; 10（6.4% ） ceses had stent migration; 3 （ 1.9% ） cases had tracheal malacia; 4（2. 6% ）cases had tracheal fiscula; 5 （3.2%）cases had recurrent laryngeal nerve involvement causes hoarseness. There were 37 cases died in 6 to 60 mounths. 97 patients existent breathing smoothly, no sputum obstruction of the trachea. Conclusion： Interventional therapy is a simple, safe and effective method for the treatment of tracheobronchial benign and malignant stenosis, It could improve patients＇ liveing quality.