球囊扩张引导术在恶性复杂气道狭窄Y型硅酮支架置入困难时的应用

Application of balloon dilatation-guided placement difficult Y-style silicone stent in thetreatment of malignant complex tracheal stenosis

目的探讨球囊扩张引导术在恶性复杂气道狭窄Y型硅酮支架置入困难治疗中的有效性及安全性。方法本文为观察性研究。回顾性选取2021年8月至2022年3月在济宁市第一人民医院呼吸介入诊疗中心诊断为重度气道狭窄经常规方法置入硅酮支架失败的患者6例。其中男4例,女2例,年龄(62±7)岁;单侧支气管狭窄伴隆突增宽3例,双侧主支气管狭窄伴隆突增宽3例;4例患者为肺部恶性肿瘤,2例患者为食管癌侵犯气道。在恶性复杂气道狭窄Y型硅酮支架置入过程中联合球囊扩张引导术。观察Y型硅酮支架置入成功率、术中及术后并发症等指标。结果6例患者均成功置入Y型硅酮支架,术中、术后均无并发症发生,无操作相关死亡病例。术后患者气道狭窄均解除,呼吸困难均明显缓解,呼吸困难分级由Ⅲ~Ⅳ级改善为0~Ⅱ级。结论球囊扩张引导术在恶性复杂气道狭窄Y型硅酮支架置入困难时应用安全、有效。

Objective To investigate the efficacy and safety of balloon dilatation-guided placement difficult Y-style silicone stent in the treatment of malignant complex tracheal stenosis.Methods This was an observational study.A retrospective study was conducted on 6 patients diagnosed with severe tracheal stenosis who failed to undergo conventional silicone stent implantation in the Respiratory Intervention Diagnosis and Treatment Center of Jining No.1 People's Hospital from August 2021 to March 2022.There were 4 males and 2 females,aged(62±7)years.There were 3 cases of unilateral bronchial stenosis with protrusion widening,and 3 cases of bilateral main bronchial stenosis with protrusion widening.Four patients had pulmonary malignancies and two patients had esophageal cancer invading the airway.In the process of Y-style silicone stent implantation for malignant complex airway stenosis,6 patients with difficult stent implantation were treated with balloon dilatation-guided technique.The indicators of successful Y-style silicone stent placement and intraoperative and postoperative complications were observed.Results The Y-style silicone stents were successfully placed in all 6 patients,and there were no intraoperative or postoperative complications.There were no operation-related deaths.After operation,the patients'tracheal stenosis was relieved,the dyspnea was significantly relieved,and the grade of dyspnea was improved from gradeⅢ-Ⅳto grade 0-Ⅱ.Conclusion Balloon dilatation-guided placement difficult Y-style silicone stent in the treatment of malignant complex tracheal stenosis is effective and safe.