超细支气管镜引导置入气管支架治疗恶性气道狭窄的临床疗效  

Clinical efficacy of endotracheal stent implantation guided by ultra-thin bronchoscope in the treatment of malignant airway stenosis

作　　者：张芳 张艳 王高文 张艰 潘涛 任新玲 ZHANG Fang;ZHANG Yan;WANG Gaowen;ZHANG Jian;PAN Tao;REN Xinling(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Air Force Military Medical University,Shaanxi Xi'an 710032,China;Department of Oncology,the Second Affiliated Hospital of Guangzhou Medical University,Guangdong Guangzhou 510260,China;Department of Respiratory Medicine,Shenzhen University General Hospital,Guangdong Shenzhen 518055,China)

机构地区：[1]空军军医大学第一附属医院呼吸与危重症医学科,陕西西安710032 [2]广州医科大学第二附属医院肿瘤科,广东广州510260 [3]深圳大学总医院呼吸内科,广东深圳518055

出　　处：《现代肿瘤医学》2021年第22期3949-3953,共5页Journal of Modern Oncology

基　　金：国家自然科学基金项目(编号:81871880);陕西省科技厅项目(编号:2019JQ889)。

摘　　要：目的:整理并分析22例晚期严重恶性气道狭窄患者经超细支气管镜引导置入气管支架治疗的资料,进行临床疗效的回顾性分析。方法:收集整理我院呼吸科收治的22例晚期严重恶性气道狭窄患者经超细支气管镜引导下行气管支气管支架置入术治疗的病例资料,分析支架置入前后气促评分、ECOG评分、血气分析及并发症变化情况,以及后期疗效的随访。结果:22例患者均成功置入气管支气管支架,置入后呼吸困难症状迅即缓解,气促评分、ECOG评分及血气分析指标PaO_(2)、PaCO_(2)显著改善,差异有统计学意义。部分患者有咳嗽、咯血、吞咽困难等轻微并发症,经对症治疗后好转。术后1周随访未出现气道阻塞、支架移位等并发症;术后随访1年,仍有8例患者接受抗肿瘤治疗并持续获益。结论:晚期严重恶性气道狭窄者可经局麻下超细支气管镜引导置入气管支架迅速改善临床症状,并发症少,部分患者可延长生存期并持续获益。Objective:To collect and analyze the data of 22 patients with advanced severe malignant airway stenosis treated with endotracheal stent guided by ultra-thin bronchoscope.Methods:The data of 22 patients with severe malignant airway stenosis treated with tracheobronchial stent implantation guided by ultra-thin bronchoscope were collected in the respiratory department of our hospital.The changes of shortness of breath score,ECOG score,blood gas analysis,complications and efficacy follow-up were observed before and after stent implantation.Results:All the 22 patients were successfully treated with tracheobronchial stents.Dyspnea symptoms were immediately relieved after implantation.The shortness of breath score,ECOG score,PaO_(2) and PaCO_(2) were significantly improved,the difference was statistically significant.Some patients had cough,hemoptysis,dysphagia and other minor complications,which were gradually improved after symptomatic treatment.There were no complications such as airway obstruction and stent displacement during the follow-up one week after the operation.After 1 year of postoperative follow-up,8 patients still received antitumor therapy and continued to benefit.Conclusion:In patients with advanced severe malignant airway stenosis,tracheal stents can be placed under the guidance of ultra-thin bronchoscope under local anesthesia to quickly improve the clinical symptoms,with fewer complications,and some patients can prolong their survival period and continue to benefit.

关 键 词：超细支气管镜 气管支架 恶性气道狭窄 临床疗效 

分 类 号：R730.6[医药卫生—肿瘤]