现场改制金属封堵支架治疗支气管胸膜瘘

On-site modified metal sealing stent for treating bronchopleural fistula

目的评估现场改制金属封堵支架用于治疗术后支气管胸膜瘘的效果及安全性。方法纳入17例术后支气管胸膜瘘患者,以现场加工改制的金属覆膜封堵支架封堵瘘口,评估封堵效果、临床疗效及并发症。结果17例中,15例(15/17,88.24%)首次加工改制并置入支架成功。封堵后平均随访(150.4±72.5)天,12例(12/17,70.59%)于其后4~212天成功拔除胸腔引流管,10例(10/17,58.82%)于其后21~406天成功取出支架;治疗有效率为82.35%(14/17)。治疗后不良反应包括支架内痰液潴留13例(13/17,76.47%)、支架边缘肉芽增生11例(11/17,64.71%)、2型呼吸衰竭和肺部感染各1例(1/17,5.88%);未见窒息、大出血、气管破裂及恶性心血管事件等严重不良反应。结论现场改制金属封堵支架用于治疗术后支气管胸膜瘘效果较好且安全。

Objective To observe the effect and safety of on-site modified metal sealing stent for treating postoperative bronchopleural fistula.Methods Seventeen patients with postoperative bronchopleural fistula were enrolled,and the fistula was occluded with on-site processed and modified metal sealing stent.Then sealing effect,clinical efficacy and incidence of complications were evaluated.Results The on-site modified metal sealing stent was successfully initially implanted in 15 cases(15/17,88.24%).The average postoperative follow-up period was(150.4±72.5)days.The thoracic drainage tube was successfully removed in 12 cases(12/17,70.59%)4 to 212 days after closure,while the stent was successfully removed in 10 cases(10/17,58.82%)21—406 days after occlusion.The effective rate of treatment was 82.35%(14/17).The adverse reactions after treatment included sputum retention in stents in 13 cases(13/17,76.47%),granulation hyperplasia at the edge of the stent in 11 cases(11/17,64.71%),type 2 respiratory failure in 1 case(1/17,5.88%)and pulmonary infection in 1 case(1/17,5.88%).No serious adverse reaction such as asphyxia,massive bleeding,airway rupture nor malignant cardiovascular events occurred.Conclusion On-site modified metal sealing stent was effective and safe for treating postoperative bronchopleural fistula.