CAJ | 학술논문

目的：探讨在全身麻醉下采用单导丝引导Y型气道支架置入的方法和临床应用。方法接受气道Y型支架治疗复杂气管疾病患者6例，其中气管胸膜瘘1例，食管－气管瘘2例，气道复合型狭窄3例。全身麻醉后在DSA监视下对6例患者置入气道Y型支架。结果6例患者共置入Y型气道支架6枚，均为单导丝引导置入，其中1例支架右侧分支误入右肺上叶支气管内，余5例支架置入均一次获得成功。结论全麻下Y型气道支架置入术能有效封堵支气管残端胸膜瘘、左主支气管食管瘘，能快速有效解除气管隆突区复合性气道狭窄，近期疗效显著，手术安全、可靠，单导丝引导置入技术操作相对于双导丝引导置入技术操作简单、快速有效、值得推广应用。
목적：탐토재전신마취하채용단도사인도Y형기도지가치입적방법화림상응용。방법접수기도Y형지가치료복잡기관질병환자6례，기중기관흉막루1례，식관－기관루2례，기도복합형협착3례。전신마취후재DSA감시하대6례환자치입기도Y형지가。결과6례환자공치입Y형기도지가6매，균위단도사인도치입，기중1례지가우측분지오입우폐상협지기관내，여5례지가치입균일차획득성공。결론전마하Y형기도지가치입술능유효봉도지기관잔단흉막루、좌주지기관식관루，능쾌속유효해제기관륭돌구복합성기도협착，근기료효현저，수술안전、가고，단도사인도치입기술조작상대우쌍도사인도치입기술조작간단、쾌속유효、치득추엄응용。
Objective To discuss the technical points and the clinical application of single wire-guided inverted Y-shaped tracheal stent implantation under general anesthesia in treating complex tracheal diseases. Methods During the period from January 2014 to October 2014 at authors’ hospital, a total of 6 patients with complex tracheal diseases received inverted Y-shaped tracheal stent implantation. The diseases included trachea-pleural fistula(n=1), trachea-esophageal fistula(n=2) and complex tracheal stenosis(n=3). Under general anesthesia and guided by DSA, inverted Y-shaped tracheal stent implantation was carried out in all the 6 patients. The results were analyzed. Results A total of 6 Y-shaped tracheal stents were used in the 6 patients, and single wire-guided implantation technique was employed in all procedures. In one case , the right branch of the Y-shaped tracheal stent was placed in the right upper lobe bronchus by mistake , and in the remaining 5 cases the stent implantation was successfully accomplished with single manipulation. Conclusion Under general anesthesia, Y-shaped tracheal stent implantation can effectively obstruct the trachea-pleural fistula and left main bronchus-esophageal fistula, and it can also quickly and significantly relieve the complex airway stenosis located at the tracheal carina region. This treatment is safe and reliable with satisfactory short-term effect. Moreover, single wire-guided manipulation is technically simpler, easier and faster than dual wire-guided manipulation. Therefore, this technique should be recommended in the clinical practice.