Y型硅酮气道支架置入治疗复合气道病变

Y-shaped silicone airway stent placement for complex airway diseases

摘要:

目的 初步探讨Y型硅酮气道支架置入治疗气管下段、气管隆突、双主支气和气管食管瘘等复合病变的可行性和疗效。方法 根据气道复合病变的特殊解剖结构，设计并裁剪气道Y型硅酮支架，在全麻硬质支气管镜引导下，对7例气道复合病变患者置入Y型硅酮支架7枚。结果 Y型硅酮支架均一次性置入成功，7例患者置入内支架后症状均缓解，呼吸困难分级由Ⅲ～Ⅳ级改善为0～Ⅱ级，脉搏血氧饱和度（SpO2）高流量吸氧时的77.0%～90.0%[平均为（84.1±4.5）%]提高至自然呼吸时的90.0%～99.0%[平均为（94.1±2.9）%]，与术前比较差异有统计学意义（P =0.000），主要并发症为咳嗽、异物感、胸痛、肉芽形成和痰液潴留。结论 气道Y型硅酮支架置入能有效解除气道复合病变，技术可行，操作相对简单、安全，近期疗效可靠，值得进一步推广应用。

Abstract:

Objective To investigate the feasibility and therapeutic efficacy of inverted Y-shaped silicone airway stent for complex airway diseases (stenosis or fistula). Methods According to the particular anatomic structure and the pathological changes of complex airway diseases, the inverted Y-shaped silicone airway stents were designed. 7 stents were implanted in 7 cases of airway complex diseases with the guidance of interventional rigid bronchoscope under general anesthesia. Results The Y-shaped silicone stents were placed successfully followed with the result of immediate relieves of the symptoms. Dyspnea grade was improved significantly from Ⅲ～Ⅳ to 0～Ⅱ, and oxygen saturation elevated from ( 84.1 ± 4.5 ) % in inspiring high concentration oxygen to ( 94.1 ± 2.9 ) % in breathing ambient air (P = 0.000). The main complications were cough, foreign body sensation, chest pain, granulation, sputum retention, et al. Conclusion Placement of Y-shaped silicone airway stent is a feasible and safe treatment for complex airway disease, the recent curative effect is reliable, it is worth further promoting.