新型经支气管镜工作孔道释放的金属气道支架对恶性中央气道狭窄的治疗观察

Observation of new through-the-scope metallic stent in treatment of malignant central airway stenosis

目的镍钛合金气道支架是治疗恶性中央气道狭窄患者的最直接有效的方法之一。传统的OTW金属气道支架置入系统操作步骤较繁琐,定位精确性有待提高。本研究主要探讨自主研发的新型经支气管镜工作孔道释放的金属气道支架(TTS支架)在恶性中央气道狭窄中的应用及护理要点。方法回顾分析了本单位在前期研究中利用该TTS支架成功治疗了26例恶性中央气道狭窄患者。分析其支架置入前后的气道狭窄率、呼吸困难程度、支架治疗效果、并发症。结果在支架置入后,患者的气道狭窄率从术前(83.93±10.05)%减小到(24.43±7.27)%(P<0.001),呼吸困难评分从术前的2.54±1.14减少为0.86±0.59(P<0.001),所有病人均未出现明显的并发症。结论该新型TTS气道支架能够有效的快速缓解恶性中央气道狭窄患者的呼吸困难,并且对于助手配合的要求更简单,有可能优于OTW型支架置入系统。

Objective Nitinol stent is one of the most direct and effective methods in the treatment of malignant central airway stenosis.The traditional OTW metal airway stent placement system is cumbersome,and its positioning accuracy needs to be improved.The purpose of this study was to explore the application and nursing points of a new through-the-scope(TTS)stent in malignant central airway stenosis.Methods 26 patients with malignant central airway stenosis were treated by TTS stent in our previous study.The rate of airway stenosis,the degree of dyspnea,the effect of stent therapy,complications and nursing points were analyzed.Results After stenting,the rate of airway stenosis was reduced from 83.93±10.05%to 24.43±7.27%(P<0.001),and the score of dyspnea was reduced from 2.54±1.14 to 0.86±0.59(P<0.001).There was no significant complications in all patients.In addition,only two people were required to participate in the placement of TTS metal airway stent,which made the nursing cooperation more simple.Conclusion It concludes that the new TTS stent can effectively and rapidly relieve the dyspnea of patients with malignant central airway stenosis,and the requirements for nursing cooperation are simpler,which may be better than the OTW stent placement system.