安徽医药
安徽醫藥
안휘의약
ANHUI MEDICAL AND PHARMACEUTICAL JOURNAL
2014年
5期
847-850
,共4页
气管支气管狭窄%纤维支气管镜%支架%双乳胶管
氣管支氣管狹窄%纖維支氣管鏡%支架%雙乳膠管
기관지기관협착%섬유지기관경%지가%쌍유효관
tracheobronchial stenosis%fiberoptic bronchoscopy%stent%double latex-tubes
目的：探讨床旁纤维支气管镜辅助下，利用双乳胶管协助置入气管支架治疗急性重度恶性气道狭窄病人的临床疗效。方法对该院2004年1月-2013年7月，因突发或进行性呼吸困难就诊，床旁纤维支气管镜下采用双乳胶管辅助置入气管支架的23例急性重度恶性气道狭窄的病例进行回顾性分析。结果23例患者置入支架24枚（1例右主支气管内复发性恶性狭窄并中央气道外压性狭窄患者同期置入2枚支架），准确率100％，操作时间180～300 s，平均为（247．96±37．94）s，操作时间短，患者容易耐受，术中未出现大咯血、窒息等严重并发症；支架置入后围手术期和短期（≤30 d）有效率均为100％。随访2～6个月不等，随访结束后生存率为47．83％，并发症发生率21．74％，包括支架移位、肉芽过度增生甚至向腔内生长。结论床旁纤维支气管镜辅助下，采用双乳胶管协助急性重度恶性气道狭窄病人置入气管支架，安全准确、快速简单、疗效确切，近期和中期（≤6个月）无管腔再狭窄、支架碎裂等严重并发症；支架置入后需定期随访。
目的：探討床徬纖維支氣管鏡輔助下，利用雙乳膠管協助置入氣管支架治療急性重度噁性氣道狹窄病人的臨床療效。方法對該院2004年1月-2013年7月，因突髮或進行性呼吸睏難就診，床徬纖維支氣管鏡下採用雙乳膠管輔助置入氣管支架的23例急性重度噁性氣道狹窄的病例進行迴顧性分析。結果23例患者置入支架24枚（1例右主支氣管內複髮性噁性狹窄併中央氣道外壓性狹窄患者同期置入2枚支架），準確率100％，操作時間180～300 s，平均為（247．96±37．94）s，操作時間短，患者容易耐受，術中未齣現大咯血、窒息等嚴重併髮癥；支架置入後圍手術期和短期（≤30 d）有效率均為100％。隨訪2～6箇月不等，隨訪結束後生存率為47．83％，併髮癥髮生率21．74％，包括支架移位、肉芽過度增生甚至嚮腔內生長。結論床徬纖維支氣管鏡輔助下，採用雙乳膠管協助急性重度噁性氣道狹窄病人置入氣管支架，安全準確、快速簡單、療效確切，近期和中期（≤6箇月）無管腔再狹窄、支架碎裂等嚴重併髮癥；支架置入後需定期隨訪。
목적：탐토상방섬유지기관경보조하，이용쌍유효관협조치입기관지가치료급성중도악성기도협착병인적림상료효。방법대해원2004년1월-2013년7월，인돌발혹진행성호흡곤난취진，상방섬유지기관경하채용쌍유효관보조치입기관지가적23례급성중도악성기도협착적병례진행회고성분석。결과23례환자치입지가24매（1례우주지기관내복발성악성협착병중앙기도외압성협착환자동기치입2매지가），준학솔100％，조작시간180～300 s，평균위（247．96±37．94）s，조작시간단，환자용역내수，술중미출현대각혈、질식등엄중병발증；지가치입후위수술기화단기（≤30 d）유효솔균위100％。수방2～6개월불등，수방결속후생존솔위47．83％，병발증발생솔21．74％，포괄지가이위、육아과도증생심지향강내생장。결론상방섬유지기관경보조하，채용쌍유효관협조급성중도악성기도협착병인치입기관지가，안전준학、쾌속간단、료효학절，근기화중기（≤6개월）무관강재협착、지가쇄렬등엄중병발증；지가치입후수정기수방。
Objective To explore the clinical efficacy of the placement of tracheobronchial stents with help of fiberoptic bronchoscopy and double latex-tubes at the sickbed to treat the acute ,severe and malignant tracheobronchial stenosis .Methods For having a sudden or pro gressive difficulty in breathing ,23 patients with the acute , severe and malignant tracheobronchial stenosis admitted to hospital from January 2004 to July 2013 were stented in aid of self-made double latex-tubes as labels via fiberoptic bronchoscopy at the sickbed and retrospective analysis was made .Results Twenty-three patients were implanted with 24 stents successfully ( 1 patient who had a recurrent malignant stenosis in right main bronchus and a pressured stenosis in the central airway was placed with two stents at one time).The rate of accuracy was 100%.It cost 180~300 s on operation,averaging(247.96 ±37.94) s.The peri-operative and short-term(≤30days) efficiencies were 100%.After stenting,23 cases were followed up for 2 to 6 months.The survival rate was 47.83%, and the rate of complications was 21.74%,which included migration ,excessive granulation ,even proliferation into stent cavity .Conclu-sions It’s safe,accurate,quick and simple to implant stents by using double latex-tubes auxiliary via fiberoptic bronchoscopy to treat patients with acute ,severe and malignant airway stenosis .In these patients it is imperative that tracheobronchial stenting be considered for symptomatic relief and improvement of quality of life .At the same time,there are not severe complications like re-stenosis and frac-ture within 6 months.Therefore,patients should be followed up at a regular time after stenting .
