硅酮支架在良性气道狭窄中的临床应用

Application of Dumon silicone airway stent in benign airway stenosis

摘要:

摘要：目的??探讨气道硅酮支架对良性中心气道狭窄的疗效及安全性。方法 收集因良性中心气道狭窄行气道硅酮支架置入术的患者资料共14例次，分析统计围手术期并发症、近期疗效、支架相关并发症和远期疗效等。结果 14例次硅酮支架置入术均成功完成，无严重围手术期并发症，11例次气管狭窄患者血氧饱和度从术前高流量吸氧下平均（86.4±4.8）%改善到术后未吸氧下平均（95.0±2.4）%，术前术后比较，差异有统计学意义（t?=?-9.42，P?=?0.000），3例次主支气管狭窄患者的狭窄远端反复感染状况在支架置入后得到控制。14例次患者中，成功取出硅酮支架达到预期疗效11例次，有效率为78.6%（11/14），气道狭窄最窄处平均直径从术前的（5.6±1.1）mm增加到支架取出时的（12.1±2.2）mm，术前术后比较，差异有统计学意义（t?=?-13.66，P?=?0.000），支架置入时间199～729 d（中位置入时间352 d，四分位数间距201.5 d）。对6例次狭窄改善的患者进行了随访，1例次复发狭窄，复发狭窄率16.7%（1/6）。支架相关并发症中，肉芽增生发生率71.4%（10/14），声音嘶哑发生率7.1%（1/14），咳痰困难发生率64.3%（9/14），支架移位发生率21.4%（3/14）。结论 气道硅酮支架治疗良性中心气道狭窄，具有良好的近期及远期疗效，安全性较高。

Abstract:

Abstract: Objective ?To study the efficacy and safety of airway silicone stent in treatment of benign central airway stenosis.?Methods?Clinical data of 14 cases with benign central airway stenosis treated with silicone stent implantation were collected. Perioperative complications, short-term efficacy, stent-related complications and long-term effects were analyzed.?Results?14 cases of silicone stent implantation were completed successfully without serious perioperative complications. The average blood oxygen saturation of 11 patients with tracheal stenosis was improved from (86.4?±?4.8)% under high flow oxygen inhalation before operation to (95.0?±?2.4)% without oxygen inhalation after operation. The difference was statistically significant (t?=?-9.42, P?=?0.000). The recurrent infection of the distal part of the stenosis in 3 patients with secondary main bronchial stenosis was controlled during stent implantation. The silicone stent was successfully removed in 11 of the 14 cases and the effective rate was 78.6% (11/14). The average diameter of the narrowest part of airway stenosis increased from (5.6?±?1.1) mm before operation to (12.1?±?2.2) mm at the time of stent removal, the difference was statistically significant (t?=?-13.66, P?=?0.000). The stent implantation time was from 199 to 729 d (the median placement time was 352 d, the quartile interval was 201.5 d). 6 cases with improved stenosis were followed up, 1 case had recurrent stenosis, and the rate of recurrent stenosis was 16.7% (1/6). Among the stent-related complications, the incidence of granulation hyperplasia was 71.4% (10/14), hoarseness was 7.1% (1/14), difficulty in expectoration was 64.3% (9/14), and stent displacement was 21.4% (3/14).?Conclusion?Airway silicone stent has good short-term and long-term effect and high safety in the treatment of benign airway stenosis.