经纤维支气管镜引导气道支架置入治疗中央性气道狭窄48例临床研究

Clinical analysis of airway stent implantation under fiber bronchoscope in treating 48 patients with central airway stenosis

摘要:

目的  探讨经纤维支气管镜（纤支镜）引导置入气道支架治疗中央性气道狭窄的临床疗效及安全性。方法  选取2012年2月-2014年10月在该院住院的48例恶性中央气道狭窄患者，经纤支镜引导置入气道支架，观察气道支架置入前后患者的呼吸困难改善情况及血气分析、肺功能各指标变化，并对并发症进行分析。 结果  48例患者共置入54枚支架，一次性成功45例（93.75%），支架置入后，患者气道阻塞症状明显减轻，呼吸困难即刻缓解，与治疗前比较，治疗后血气分析、肺功能指标明显改善（P <0.05），气促评级降低（P <0.05），所有患者均未出现与支架有关的严重并发症。结论  纤支镜下气道支架置入术对于恶性气道狭窄患者安全、有效，能够迅速解除气道狭窄，缓解呼吸困难，提高生活质量，延长患者的生存时间，并为后续治疗创造条件，值得在临床推广应用。

Abstract:

【Objective】 To observe the safety and clinical efficacy of fiber bronchoscopy-guided airway stent implantation in the management of patients with central airway stenosis. 【Methods】 From February 2012 to October 2014, In our department, 48 cases with central airway stenosis caused by malignant tumor, were selected for airway stent implantation treatment guided by fiber bronchoscope. The dyspnea symptom improvement, blood-gas analysis, lung function were evaluated and compared before and after treatment, and complications were analyzed. 【Results】 A total of 54 stents were implanted in 48 patients, one-time successful 45cases (93.75%), patients with airway obstruction symptoms significantly reduce after stent implantation, dyspneic symptom was ameliorated. The clinical indexes such as blood-gas analyses, lung function were significantly improved after stenting (P < 0.05). The dyspnea degree was decreased (P < 0.05). The serious complications related to stents were not found in all cases. 【Conclusion】 In the treatment of airway stenosis caused by malignant tumor, the airway stent implantation with fiber bronchoscope guidance is safe and effective, which can quickly rescue patients from the airway stenosis, alleviate difficulty breathing ,improve the life quality of patients and prolong the survival time ,and create conditions for follow-up treatment, it is worth popularizing application in clinic.