技术改良在局麻下倒Y型金属气道支架置入治疗恶性隆突狭窄10例

Implantation of inverted Y-type metal airway stent with modified guide wire insertion technique under local anesthesia for malignant carina stenosis:initial experience in 10 patients

目的评价X线引导局麻下倒Y型金属气管支架置入过程中改良交换导丝引入方法缩短手术操作时间的技术可行性。方法回顾性分析局麻下置入倒Y型金属气道支架16例。其中6例采用常规分次加硬导丝引入,10例患者采用改良方法 ,一次性2根加硬导丝引入,技术成功率及手术操作时间作为主要观察指标。结果局麻下16例倒Y型金属气道支架均成功置入,常规方法组手术操作时间平均为15.6 min,改良组手术操作时间平均为11.1 min,两组方法比较差异有统计学意义(P<0.05)。结论改良一次性加硬导丝置入在局麻下倒Y型金属气道支架置入治疗恶性隆突狭窄能有效缩短手术操作时间。

Objective To assess the technical feasibility and effectiveness of X-ray-guided implantation of inverted Y- type metal airway stent under local anesthesia by using a modified technique of exchanging guide wire in order to shorten operation time. Methods The clinical data of a total of 16 patients, who received inverted Y-type metal airway stent implantation under local anesthesia, were retrospectively analyzed. Routine gradual guide wire exchange method with a harder one was used in 6 patients （routine group）, while in 10 patients （modification group） a modified technique of exchanging guide wire, i.e. inserting two hard wires at one time, was employed. Technical success rate and operation time were used as the main observation indexes. Results Under local anesthesia, the implantation of inverted Y-type metal airway stent was successfully accomplished in all 16 patients. The mean operation time of the routine group and the modification group was 15.6 minutes and 11.1 minutes respectively, the difference between the two groups was statistically significant （P〈0.05）. Conclusion For the performance of implantation of inverted Y- type metal airway stent under local anesthesia to treat malignant carina stenosis, the use of modified technique of guide wire insertion, i.e. inserting two hard wires at one time, can effectively shorten the operation time.