喉镜联合透视气管内支架植入术治疗晚期肿 瘤导致气管狭窄或瘘的疗效与安全性

Efficacy and safety of tracheal stent implantation with laryngoscope and DSA for the treatment of advanced cancer causing tracheal stenosis or fistula

摘要:

目的 探讨静脉局部麻醉下喉镜联合透视气管内支架植入术治疗晚期肿瘤导致气管狭窄或瘘的疗效、并发症与安全性。方法 选取该院肿瘤科收治的晚期恶性肿瘤导致气管狭窄或瘘的59例患者，在静脉局部麻醉下行喉镜联合透视气管内支架植入术，观察患者术后临床症状改善情况，对比治疗前后生命体征变化及术后并发症。结果 经过治疗后，所有患者的临床症状均得到明显改善。患者术后收缩压、舒张压和心率较术前明显降低，血氧饱和度较术前明显上升（P <0.05）；术后气促评级1级以下的比例显著高于术前（P <0.05）。术后并发症以痰中夹杂血丝最常见，占86.44%（51/59）。结论 静脉局部麻醉下喉镜联合透视气管内支架植入术能够有效改善晚期肿瘤导致的气管狭窄和气管-食管瘘所致的临床症状，延续患者生命，且安全性好，值得在临床上进一步推广。

Abstract:

【Objective】 To investigate the efficacy and safety of tracheal stent implantation with laryngoscope and DSA in the treatment of advanced cancer causing tracheal stenosis or fistula. 【Methods】 Fifty-nine patients with tracheal stenosis or fistula were selected in the tumor department of our hospital, who were treated with laryngoscope and tracheal stent implantation perspective under vein local anesthesia. The improvements of clinical symptoms were observed after the surgery. The changes of vital signs and postoperative complications were compared before and after the treatment. 【Results】 After the treatment, the clinical symptoms of all the patients were obviously improved. The systolic pressure, diastolic pressure and heart rate of the patients after the operation were significantly decreased compared with those before the operation, while the blood oxygen saturation was significantly increased (all P <0.05). The proportion of dyspnea rating below level 1 after the operation was significantly higher than that before operation(P <0.05). The most common complication was bloodshot with sputum, accounted for 86.44% (51/59). 【Conclusion】 Laryngoscope and tracheal stent implantation perspective under vein local anesthesia can effectively improve the clinical symptoms in the patients with advanced cancer causing tracheal stenosis or fistula. It can extend the lives of patients and the security is good. It's worthy of further promotion in clinical practice.