通气导管辅助下^(125)I支架植入治疗恶性气道狭窄  

^(125)I stent implantation in treatment of malignant tracheal stenosis with help of ventilation catheter

作　　者：魏宁 陈启鸿 徐浩 王文亮 张梦琦 李洪宇 蒋明明 祖茂衡 

机构地区：[1]徐州医科大学附属医院介入放射科,江苏徐州221006

出　　处：《中国介入影像与治疗学》2017年第6期327-330,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：江苏省临床医学科技专项(BL2013011)

摘　　要：目的探讨局部麻醉及通气导管辅助下^(125)I粒子气管支架治疗恶性气道狭窄的疗效。方法回顾性分析于我科接受^(125)I粒子气管支架植入术治疗的恶性气道狭窄患者180例。分析^(125)I气管支架植入前、后患者气促评级、血氧饱和度(SaO2)及呼吸频率,术后随访患者的^(125)I支架情况、临床症状及生存情况。结果 180例均成功接受^(125)I粒子气管支架植入术,共植入^(125)I支架180枚,其中筒状支架132枚、"Y"型支架34枚、"L"型支架14枚。术后患者呼吸困难症状均有显著缓解。本组患者SaO2由术前的(80.60±3.87)%提高至术后的(94.31±3.40)%,差异有统计学意义(t=-30.52,P<0.01);呼吸频率由术前的(29.36±3.20)次/分改善至术后的(19.29±2.19)次/分,差异有统计学意义(t=35.09,P<0.01)。术后随访3~13个月,6例患者出现^(125)I支架再狭窄;患者生存期为49~401天,平均(182±94)天,患者60天生存率的估计值为0.99,180天生存率的估计值为0.65。结论局部麻醉及通气导管辅助下^(125)I气管支架植入术治疗恶性气道狭窄是安全、有效的方法。Objective To explore the clinical efficacy of 125I stent implantation in treatment of malignant tracheal stenosis with the help of ventilation catheter under local anesthesia. Methods Totally 180 consecutive patients with malignant tracheal stenosis underwent ^125I airway stent implantation were analyzed retrospectively. The anhelation grade, oxygen saturation and respiratory rate before and after operation were recorded and analyzed. ^125I stent situation, clinical symptoms and survival situation were followed up after operation. Results The success rate of ^125I stent placement was 100% （180/180）, and the stent type was tubular stent in 132 cases, Y-shaped stent in 34 cases, and L-shaped stent in 14 cases. Dyspnea was significantly relived in all patients. Oxygen saturation and respiratory rate improved from （80.60±3.87）% and （29.36±3.20）times/min before operation to （94.31±3.40）% and （19.29±2.19）times/min after operation （t=-30.52, 35.09, both P〈0.01）. Patients were followed up 3-13 mouth after operation, and stent restenosis were occurred in 6 patients. The lifetime was 49-401 days and the average lifetime was （182±94） days. The 60-day survival rate was 0.99 and the 180-day survival rate was 0.65. Conclusion 125I stent implantation in treatment of malignant tracheal stenosis with the help of ventilation catheter under local anesthesia is a safe and effective method.

关 键 词：气道狭窄 支架 ^125I粒子 治疗结果 

分 类 号：R730.5[医药卫生—肿瘤]