局麻下数字减影血管造影引导Y型气管支架置入治疗恶性气道狭窄  

Digital subtraction angiography guided Y-type tracheal stent implantation under local anesthesia for malignant airway stenosis

作　　者：王秋香[1] 李顺宗[1] 李智岗[1] 杨光[1] WANG Qiuxiang;LI Shunzong;LI Zhigang;YANG Guang(Department of Radiolog y,the Fourth Hos pital of Hebei Medical University,Shij iazhuang,Hebei Province 050011,China)

机构地区：[1]河北医科大学第四医院放射科,河北石家庄050011

出　　处：《实用放射学杂志》2021年第11期1885-1888,共4页Journal of Practical Radiology

摘　　要：目的探讨局麻下数字减影血管造影(DSA)引导Y型气管支架置入治疗恶性气道狭窄的可行性、并发症及疗效。方法局麻下DSA引导的方法对58例恶性气道狭窄患者施行Y型气管支架置入术。结果(1)58例患者中54例气管支架1次成功置入,4例2次成功置入,技术成功率达100%。(2)术中无大咯血、窒息等致命性并发症,术后大部分患者出现咳嗽、少量咯血、胸背部疼痛等轻微并发症,8例患者出现支架再狭窄,5例患者出现大咯血,1例患者出现支架解体,无移位、脱落者。(3)术后患者呼吸困难症状均得到即刻缓解,动脉血氧饱和度由术前(83.56±3.12)%升高至术后(98.24±1.16)%,差异有统计学意义(P<0.05)。(4)气管支架平均通畅时间为7.86个月,术后3、6、12个月气管支架通畅率分别为96.56%、82.71%、65.2%,术后患者平均生存期为8.63个月。结论局麻下DSA引导Y型气管支架置入术是一种安全、可行、疗效确切、快速解决恶性气道狭窄的治疗手段,值得临床广泛推广应用。Objective To investigate the feasibility,complications and efficacy of digital subtraction angiography(DSA)guided Y-type tracheal stent implantation for malignant airway stenosis under local anesthesia.Methods Fifty-eight patients with malignant airway stenosis were treated with Y-type tracheal stent implantation under local anesthesia guided by DSA.Results(1)Of the fifty-eight patients,fifty-four patients were successfully implanted tracheal stents at one time,and four patients were successfully implanted the second time.The technical success rate was 100%.(2)There were no fatal complications such as massive hemoptysis or asphyxia during the operation.After operation,most of the patients had mild complications such as cough,a small amount of hemoptysis,and chest and back pain.Eight patients had stent restenosis,five patients had massive hemoptysis,one patient had stent disintegration,and no patients had stent displacement or shedding.(3)After the operation,the symptoms of dyspnea were relieved immediately.The arterial oxygen saturation increased from(83.56±3.12)%before operation to(98.24±1.16)%after operation,and the difference was statistically significant(P<0.05).(4)The average patency time of tracheal stent was 7.86 months.The patency rate of tracheal stent was 96.56%,82.71%and 65.2%at 3,6 and 12 months after operation,respectively.The average survival time was 8.63 months.Conclusion DSA guided Y-type tracheal stent implantation under local anesthesia is a safe,feasible,effective and rapid treatment for malignant airway stenosis,which is worthy of clinical application.

关 键 词：数字减影血管造影 气管支架 气道狭窄 大咯血 

分 类 号：R614.1[医药卫生—麻醉学] R815[医药卫生—外科学]