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山东大学学报(医学版) ›› 2016, Vol. 54 ›› Issue (12): 62-66.doi: 10.6040/j.issn.1671-7554.0.2015.1364

• 临床医学 • 上一篇    下一篇

气道支架置入术治疗恶性气道狭窄伴一侧肺通气的临床研究

文芳静,史小武   

  1. 武汉市中心医院呼吸内科, 湖北 武汉 430014
  • 收稿日期:2015-12-31 出版日期:2016-12-10 发布日期:2016-12-10
  • 通讯作者: 史小武. E-mail:sandyshi125@163.com E-mail:sandyshi125@163.com

Clinical research of stent placement by electronic bronchoscopy on malignant airway stenosis with one side lung ventilation

WEN Fangjing, SHI Xiaowu   

  1. Department of Respiratory Disease, Central Hospital of Wuhan, Wuhan 430014, Hubei, China
  • Received:2015-12-31 Online:2016-12-10 Published:2016-12-10

摘要: 目的 评价气道支架置入术在恶性气道狭窄伴一侧肺通气治疗中的价值。 方法 选择2011年1月至2015年2月武汉市中心医院呼吸内科收住的34例恶性气道狭窄伴一侧肺通气的患者,根据狭窄的病因、部位行支架置入术,评价近期疗效、气道开放程度和肺功能及并发症情况。 结果 支架置入术后34例患者呼吸困难症状明显缓解,狭窄段直径增大,气促评级改善,1秒用力呼气容积(FEV1)及动脉血氧分压(PaO2)上升,二氧化碳分压(PaCO2)改善,差异有统计学意义(P<0.05)。2周内不良反应:刺激性咳嗽7例(20.59%),咽痛9例(26.47%),咯血10例(29.41%);随访1个月并发症:肉芽组织增生3例(8.82%),排痰困难5例(14.71%),均给予对症处理后改善,1例(2.94%)27 d后大咯血死亡。 结论 电子支气管镜下气道支架置入术治疗恶性气道狭窄伴一侧肺通气的可靠性和安全性较高,值得临床推广。

关键词: 气道支架, 恶性气道狭窄, 一侧肺通气

Abstract: Objective To evaluate the value of airway stent placement by electronic bronchoscopy on malignant airway stenosis with one side lung ventilation. Methods Thirty-four patients in the Department of Respiratory Disease of Central Hospital of Wuhan from January 2011 to February 2015 were included. Airway stent was used to evaluate the short-term therapeutic effects, airways opening degree, pulmonary functions and complications. Results Follow up for one month, the symptoms of dyspnea were relieved. Airway diameter, dyspnea score, forced expiratory volume in one second(FEV1), partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2)were improved significantly(P<0.05). Adverse reactions in 2 weeks were cough(7 cases, 20.59%), sore throat(9 cases, 26.47%), and hemoptysis(10 cases, 29.41%). With the follow-up for one month,airway granulation proliferation occurred in 3 patients(8.82%), sputum drainage difficulty in 5 patients(14.71%), and 1 patient(2.94%)died because of massive hemoptysis after 27 days. Conclusion Stent placement by electronic bronchoscopy for malignant airway stenosis with one side lung ventilation is effect and safe, worthy to be promoted clinically.

Key words: Airway stent, Malignant airway stenosis, One side lung ventilation

中图分类号: 

  • R562
[1] Rooney CP, Ferguson JS, Barnhart W, et al. Use of 3-Dimensional computed tomography reconstruction studies in the preoperative assessment of patients undergoing balloon dilatation for tracheobronchial stenosis[J]. Respiration, 2005, 72(6): 579-586.
[2] Burningham AR, Wax MK, Andersen PE, et al. Metallic tracheal stents:complications associated with long-term use in the upper airway[J]. Ann Otol Rhinol Laryngol, 2002, 111(4): 285-290.
[3] Begnaud A, Connett JE, Harwood EM, et al. Measuring central airway obstruction. What do bronchoscopists do?[J]. Ann Am Thorac Soc, 2015, 12(1): 85-90.
[4] 张杰, 王娟, 党斌温, 等. 重度气道狭窄置放国产镍钛记忆合金支架的方法学研究[J].中华结核和呼吸杂志, 2010, 33(1): 25-28. ZHANG Jie, WANG Juan, DANG Binwen, et al. Evaluation of domestically made recalled nitinol alloy stent implantation for severe airway stenosis[J]. Chin J Tuberc Respir Dis, 2010, 33(1): 25-28.
[5] 李强. 介入肺脏病学的临床应用现状与展望[J].中华结核和呼吸杂志,2008,31(1):3-5.
[6] Mroz RM, Kordecki K, Kozlowski MD, et al. Severe respiratory distress caused by central airway obstruction treated with self-expandable metallic stents[J]. J Physiol Pharmacol, 2008, 59(6): 491-497.
[7] 王洪武. 严格掌握气管支架适应证,及时处理并发症[J].中华结核和呼吸杂志,2014,37(3):221-222.
[8] Lee P, Kupeli E, Mehta AC. Airway stents[J]. Clin Chest Med, 2010, 31(1): 141-150.
[9] 王广发. 中心气道狭窄的介入治疗[J].中华结核和呼吸杂志,2003,26(7):388-391.
[10] 金发光,傅恩清,谢永宏,等.难治性中心气道狭窄的综合介入治疗[J].中华结核和呼吸杂志, 2010, 33(1): 21-24. JIN Faguang, FU Enqing, XIE Yonghong, et al. The application of combined interventional procefures for the management of intratable central airway stenosis[J]. Chin J Tuvere Respir Dis, 2010, 33(1): 21-24.
[11] Casal RF. Update in airway stents[J]. Curr Opin Pulm Med, 2010, 16(4): 321-328.
[12] Lemaire A, Burfeind WR, Toloza E, et al. Outcomes of tracheobronchial stents in patients with malignant airway disease[J]. Ann Thorac Surg, 2005, 80(2): 434-438.
[13] 顾颖,卢惠宇,张大忠,等.气管支架联合放化疗治疗气管支气管肺癌气道狭窄[J].中国肿瘤临床, 2009, 36(21): 1223-1224.
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