CAJ | 학술논문

目的分析雾化吸入局麻下喉镜联合透视气管内支架植入术治疗晚期肿瘤导致气管狭窄或瘘的疗效，并发症和安全性。方法收集江苏省肿瘤医院2001年6月至2010年6月74例晚期肿瘤导致气管狭窄或瘘患者（狭窄60例，瘘14例），采用德国百瑞压缩雾化吸入器行咽喉气管支气管黏膜表面麻醉，在数字减影血管成像透视下进行体表标记定位，经口喉镜明视下插入泥鳅导丝入气道，置换交换导丝，运用支架输送器释放气管内支架。结果 74例患者均成功置入支架。60例气道狭窄患者中，有6例累及气管隆突，置入袖状支架，其余均为单纯金属裸支架。14例瘘患者，使用的均为覆膜支架。患者术后无明显改善2例，余72例患者术后全部气道恢复通畅，血氧饱和度接近正常。长期咽痛1例，刺激性呛咳2例，咳痰3例，痰中血块3例，痰中偶有血丝64例，气管支架移位1例，气管支架下缘气管食管瘘形成1例。结论局麻下喉镜联合透视技术行气管内支架植入可有效解除气道狭窄及堵瘘。
목적 분석무화흡입국마하후경연합투시기관내지가식입술치료만기종류도치기관협착혹루적료효，병발증화안전성。방법 수집강소성종류의원2001년6월지2010년6월74례만기종류도치기관협착혹루환자（협착60례，루14례），채용덕국백서압축무화흡입기행인후기관지기관점막표면마취，재수자감영혈관성상투시하진행체표표기정위，경구후경명시하삽입니추도사입기도，치환교환도사，운용지가수송기석방기관내지가。결과 74례환자균성공치입지가。60례기도협착환자중，유6례루급기관륭돌，치입수상지가，기여균위단순금속라지가。14례루환자，사용적균위복막지가。환자술후무명현개선2례，여72례환자술후전부기도회복통창，혈양포화도접근정상。장기인통1례，자격성창해2례，해담3례，담중혈괴3례，담중우유혈사64례，기관지가이위1례，기관지가하연기관식관루형성1례。결론 국마하후경연합투시기술행기관내지가식입가유효해제기도협착급도루。
Objective To assess the efficacy and safety of airway stenting with inhalation anesthesia under radiological guidance in the palliation of malignant tracheobronchial stenosis. Methods Between June 2001 and August 2010, 74 consecutive patients with malignant tracheobronchial stenosis were treated by the insertion of an ultraflex self-expandable metal stent with inhalation anesthesia under fluoroscopic guidance. Results All patients achieved obvious symptomatic relief. The outcomes were as follows: dyspnea ( n =2 ), long-term angina ( n =1 ), strong irritation cough ( n =2 ), hard phlegm ( n =3 ), clotting expectoration ( n =3 ), blood-tinged expectoration ( n =64 ), airway stent displacement ( n =1 ) and tracheoesophageal fistulas ( n =1 ). Conclusion Performed with inhalation anesthesia under radiological guidance, tracheobronchial recanalization with a self-expandable metal stent is a safe and effective palliative treatment for malignant stenosis.