气道内被膜支架治疗特殊部位气道消化道瘘

Clinical effect of tracheal membrane-covered stent implantation in the treatment of malignant tracheoesophageal fistula in unusual site

目的探讨气道内被膜支架置入治疗特殊部位食管肿瘤性消化道气道瘘的临床疗效及安全性。方法 12例食管癌消化道气道瘘在纤维支气管镜或配合X线透视下行气道内被膜支架置入封堵治疗,比较治疗前后病人咳嗽、呼吸困难、生活质量及随访情况。结果 12例食管癌消化道气道瘘在纤维支气管镜或配合X线透视下行气道内被膜支架置入封堵治疗均取得成功,12例病人术后咳嗽、呼吸困难、生活质量均明显改善,比较有显著差异(P<0.05)。随访全部病人未出现严重并发症及不良反应。结论特殊部位气道消化道瘘选择不同形状气道内支架置入封堵瘘口,疗效好,操作安全、并发症少,值得临床应用。

Objective To evaluate the safety and clinical efficacy of tracheal membrane-covered stent implantation in the treatment of malignant tracheoesophageal fistula in unusual site. Methods Membrane-covered stents were placed into airway of 12 esophageal carcinoma patients with tracheoesophageal fistula by guidance of bronchoscopy or fluoroscopy. Therapeutic effect evaluation included comparison of degrees of cough, dyspnea and qualities of life before and after operation. Results 12 esophageal carcinoma patients with tracheoesophageal fistula were successfully placed membrane-covered tents. All patients showed significant improvements of qualities of life, symptom of cough and dyspnea compared with those before operation （P〈0. 05）. Severe complication and side effect were not observed during follow-up. Conclusion The treatment of membrane-covered stent for patients with malignant tracheoesophageal fistula in unusual site is effective, riskless, and with less complications, which deserves clinical extensive application.