^(125)I粒子支架治疗中心气道恶性狭窄的疗效观察  

Therapeutic effectiveness of nitinol stents combined with ^(125)I in patients with malignant central airway stenosis

作　　者：赵立敏[1] 郭新字[2] 张立海[3] 孙武装[3] 杨国明[3] 

机构地区：[1]河北医科大学第一医院ICU,河北石家庄050031 [2]河北医科大学第一医院精神卫生科,河北石家庄050031 [3]河北医科大学第一医院呼吸科,河北石家庄050031

出　　处：《临床荟萃》2009年第17期1499-1501,共3页Clinical Focus

摘　　要：目的探讨125I粒子自膨式镍钛合金气道支架及不携粒子镍钛记忆合金气道支架置入在治疗中心气道恶性狭窄的差异。方法44例中心气道恶性狭窄患者随机分为两组,A组26例置入不携粒子镍钛记忆合金气道支架,B组18例置入125I粒子自膨式镍钛合金气道支架,分析比较两组患者症状缓解、出血、胸痛、再狭窄、平均生存期等。结果两种类型支架置入均能使患者呼吸困难即刻改善,A组气促指数3.5±0.7 vs 1.5±0.3、脉搏血氧饱和度(SpO2)(86.0±11.2)%vs(95.0±7.7)%,B组气促指数3.6±0.5 vs 1.4±0.3、SpO2(84.0±12.4)%vs(94.6±10.2)%(均P<0.05)。两组均未出现明显支架移位,亦未发生种源移位或脱落、穿孔、气道放射性狭窄及大出血等,均无因支架置入导致的死亡。两组均有部分患者术后1~2周出现胸痛,但其差异均无统计学意义(P>0.05)。B组术后再狭窄发生率明显低于A组,16.7%vs 53.8%(P<0.05),平均生存期明显长于A组,(14.6±3.2)个月vs(10.4±2.6)个月(P<0.01)。结论125I粒子自膨式镍钛合金气道支架能明显缓解呼吸困难症状,明显提高患者生活质量及生存期,且无严重并发症。Objective To compare the therapeutic effectiveness of self-expandable nitinol stents with 125I seeds and sents without 125I seeds in patients with malignant central airway stenosis.Methods Forty-four patients with malignant central airway stenosis were randomly divided into two groups:group A(26 cases) received implantation of nitinol stents without 125I seeds and group B(18 cases) received implantation of nitinol stents with 125I seeds.Clinical symptom improvement,complications such as haemorrhage,chest pain and restenosis as well as survival intervals were evaluated.Results Dyspnea significantly decreased immediately after stent implantation in both two groups,in group A the dyspnea index was 3.5±0.7 vs 1.5±0.3 and SpO2(86.0±11.2) % vs(95.0±7.7) %,in group B the dyspnea index was 3.6±0.5 vs 1.4±0.3 and SpO2(84.0±12.4) % vs(94.6±10.2) %(all P<0.05).Complications such as stent migration,seeds migration or shedding,perforation,trachea stenosis due to radioaction and major haemorrhage were not observed in both groups.No death occurred due to stent implantation.Some patients complained chest pain in one or two weeks after operation in both groups but there was no statistical difference(P>0.05).In group B the rate of restenosis was lower than group A,16.7% vs 53.8%(P<0.05).Survival period in group B was significantly longer than group A,(14.6±3.2) months vs(10.4±2.6) months(P<0.01).Conclusion Self-expandable nitinol stents combined with 125I is effective in the treatment of malignant tracheobronchial strictures.Dyspnea can be remarkably alleviated,better quality of life and a longer survival span can be expected by this technique.

关 键 词：呼吸道肿瘤 气道阻塞 碘放射性同位素 支架 

分 类 号：R734.2[医药卫生—肿瘤]