使用气道内杂交支架治疗复杂气道狭窄和气道瘘疗效与安全性分析

Use of Hybrid Stent in Management of Complex Malignant Airway Stenosis and Fistulas

背景与目的气道内支架广泛应用于气管狭窄和气管瘘的治疗,但使用气道内支架重建复杂气道的临床数据仍不充足。硅酮支架杂交金属支架重建复杂气道的有效性和安全性。方法纳入无法手术的复杂恶性气道狭窄和气道瘘患者。使用Y型硅酮支架联合金属覆膜支架(杂交支架)重建气道。评价置入支架后6个月的疗效和并发症。结果共纳入23例患者,置入23枚Y型硅酮支架和25枚金属覆膜支架。19例患者(19/23,82.6%)置入支架后症状迅速缓解。支架平均置入(153.43±9.14)d。置入支架后改良呼吸困难指数(modified British Medical Research Council,mMRC)、卡氏功能状态(Karnofsky performance status,KPS)评分和功能状态(performance status,PS)评分显著改善。12例患者带支架生存超过6个月。其余患者肿瘤进展导致6个月内死亡。无支架置入相关死亡及严重并发症。结论杂交支架重建恶性复杂气道疗效确切,耐受良好。

Background and objective Airway stents has been widely used in airway stenosis and fistula,yet clinical date of airway stents in reestablishment a complex airway is insufficient.The aim of this study is to evaluate the ef-ficacy and safety to combine the silicon stent and the metal stent in reestablishment a complex malignant airway.Methods Patients with non-operable complex malignant airway stenosis and fistula were recruited in this study.Silicon Y stent com-bined with covered metal stent(Hybrid stent)were inserted to reestablishment the airway.Clinical outcomes and complica-tions were observed over six months.Results A total of 23 silicon Y stents and 25 covered metal stents were inserted in 23 patients.Nineteen of 23(19/23,82.6%)patients felt a immediately relieving of current symptoms.The mean duration of stents placement in patients was(153.43±9.14)days.The modified British Medical Research Council,Karnofsky Perfor-mance Status and Performance Status scale were improved significantly after stenting.A total of 12 patients living with stent at 6 months.Others dead of tumor progression.There were no death or immediate complications related to hybrid stenting implication.Conclusion Hybrid stenting proved to be useful and was well-tolerated in the management of complex malig-nant airway stenosis and fistula.