镍钛合金支架预防全喉切除术后气管造口狭窄

A study on the application of Nickle-Titanium alloys stent for prevention and treatment tracheostomal stenosis after total laryngectomy

目的 :探讨两种环行网状镍钛记忆合金 (NT SMA)支架对全喉切除术后气管造口狭窄的预防效果。方法 :应用两种NT SMA支架预防全喉切除术后气管造口狭窄 (TSS)患者 2 1例 ,其中 18例安放短型NT SMA支架 ,3例安放长型NT SMA支架。术前或术后给予放疗。结果 :Ⅰ期安放短型NT SMA支架 18例 ,伤口均Ⅰ期愈合。术后无一例气管造口狭窄 ,造口边缘光滑 ,为近似椭圆形。Ⅰ期安放长型NT SMA支架 2例 ,Ⅱ期安放长型NT SMA支架 1例 ,使狭窄的气管造口立即扩大 ,呼吸困难缓解 ,术后造口均稳定在 2cm ;但气管造口处有干痂、肉芽生长和牵张感。结论 :短型NT SMA支架固定于气管壁外 ,不但减少了对气管黏膜的刺激 ,且具有持续、均匀、柔和的支撑作用 ,能够预防全喉切除术后气管造口狭窄。长型NT SMA支架无创安放于气管腔内 。

Objective:To evaluate the effect of Nickle Titanium alloys annular stent to prevent and treatment tracheostomal stenosis after total laryngectomy. Method:The stent was used following total laryngectomy and after total laryngectomy. Result:Long stent was implanted in 2 cases following total laryngectomy and in 1 cases after total laryngectomy, Wihich resulted in widening stenosis and relieving obstruction of airway.The tracheostomal diameter is 2cm afterwards,but the patients have crusts,granuloma and stretch feeling in tracheostoma.Tracheostomaplasty was performed using short stent in 18 cases during laryngectomy.All the cases have no tracheostomal stenosis following over 6 months.The tracheostoma is smooth,enough larger and stable.Conclusion:Nickle Titanium alloys annular short stent is fixed outside the wall of trachea,its complication is less.It may prevent from tracheostomal stenosis.Nickle Titanium alloys annular long stent is a better method to resolve dyspnea.