气管恶性狭窄的内支架介入治疗  

A new interventional therapeutic technique for malignant tracheobronchial stricture with expandable metallic stents

作　　者：杨仁杰[1] 李二生[1] 丁永年 陈辉[1] 王国良 张宏志[1] 王立荣 

机构地区：[1]北京医科大学临床肿瘤学院

出　　处：《中华放射学杂志》1999年第9期621-624,共4页Chinese Journal of Radiology

基　　金：国家"九五"介入医学科技攻关资助项目!专题编号 :96 90 70 3 0 4

摘　　要：目的　介绍气管内支架留置的新技术 ,评价自张式金属内支架在气管恶性狭窄中的姑息治疗作用。方法　共 16例患者 ,其中气管腺癌所致狭窄 8例 ,食管上段鳞状上皮癌所致气管狭窄 6例 ,喉癌导致气管狭窄 2例。临床上均有不同程度的呼吸困难、喘鸣 ,2例合并食管 气管瘘者伴有呛咳。所用器械包括 :直径 14F前端部带有不透X线记号的支架释放鞘、支架推进器、导丝、导管等。所用支架为Z形不锈钢自张式支架和镍钛温度记忆合金支架。在透视监视下 ,采用经口腔、经喉气道内支架留置术。结果　全部病例气管内支架留置术均获得成功 ,没有技术上的失败。患者呼吸困难、喘鸣、呛咳等症状在支架留置后即刻改善。随访中有 2例患者因为肿瘤的过度生长而发生再狭窄 ,又留置了第 2个支架。 16例患者中 9例分别于术后 6～ 2 0个月之内死亡 ,余 7例尚在随访中。结论气管恶性狭窄的内支架成形术安全、有效 ,能明显提高患者的生活质量。Objective To introduce a new therapeutic technique of tracheal stent intubation and to evaluate the treatment effect of self expandable metallic stents in tracheal malignant stricture Methods 16 cases(male 10, female 6) were placed by intraluminal stents intubation There were 8 cases with tracheal carcinoma, 6 cases with upper segment esophageal carcinoma encroaching upon trachea and 2 cases with laryngeal carcinoma The main clinical symptoms were dyspnea, stridor and 2 cases with esophagotracheal fistula complaining of choking The instruments used were as following: 14 F stent delivery sheath with radiopaque mark at the distal portion, stent pusher, guide wire, catheter and so on Z stent and NiTi alloy stent were used In all cases, peroral laryngeal intubation of the stents was performed under fluoroscopic guidance Results All stents were successfully placed without technical failure The symptoms of dyspnea, stridor and choke were immediately relieved after finishing the stent placement procedure Conclusions Tracheal stenting is a safe, and efficient method with immediate relief of symptoms and improvement of quality of life in patients suffering from malignant tracheobronchial stricture

关 键 词：气管狭窄 介入放射学 内支架 气管肿瘤 

分 类 号：R734.104[医药卫生—肿瘤] R730.55[医药卫生—临床医学]