硅酮支架和金属覆膜支架对恶性中心气道狭窄的治疗效果比较  

Comparison on effect of silicone stent and metal covered stent on malignant central airway obstruction

作　　者：刘勇[1] 刘岩[1] 康贝贝 李广 Liu Yong;Liu Yan;Kang Beibei;Li Guang(Department of Respiratory and Critical Care Medicine,Zhoukou Central Hospital,Zhoukou 466100,China)

机构地区：[1]河南省周口市中心医院呼吸与危重症医学科,周口466100

出　　处：《中国实用医刊》2022年第4期9-12,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较硅酮支架和金属覆膜支架治疗恶性中心气道狭窄(MCAO)的效果和安全性。方法抽取2018年1月至2021年10月在周口市中心医院呼吸与危重症医学科因MCAO行气管支架置入的患者85例,根据置入支架类型分为硅酮支架组(41例)和金属覆膜支架组(44例)。观察两组患者支架置入后临床症状改善程度和不良反应发生率。结果两组患者支架置入后,呼吸困难、气促、胸闷等症状均得到缓解,气促分级和气道狭窄分级较置入前明显改善(P<0.05)。硅酮支架组分泌物潴留的发生率为75.6%(31/41),与金属覆膜支架组(86.4%,38/44)比较差异未见统计学意义(P>0.05),但金属覆膜支架组中度分泌物潴留发生率(31.8%,14/44)高于硅酮支架组(10.3%,4/41),P<0.05。硅酮支架组肉芽组织形成的发生率(34.1%,14/41)低于金属覆膜支架组的61.4%(27/44),P<0.05,但两组支架组移位发生率比较差异未见统计学意义(P>0.05)。结论硅酮支架和金属覆膜支架置入是治疗MCAO快速、直接、安全有效的临床治疗方法。与硅酮支架相比,金属覆膜支架中度分泌物潴留和肉芽形成较多,需要接受更多后续支气管镜干预措施。Objective To compare the clinical efficacy and safety of silicone stent and metal covered stent in the treatment of malignant central airway obstruction(MCAO).Methods Eighty-five patients who underwent tracheal stent implantation for MCAO in the Department of Respiratory and Critical Care Medicine of Zhoukou Central Hospital from January 2018 to October 2021 were selected.They were divided into silicone stent group(41 cases)and metal covered stent group(44 cases)according to stent types.The improvement of clinical symptoms and the incidence of adverse reactions of the two groups were observed.Results After stent implantation,the symptoms of dyspnea,shortness of breath and chest tightness were relieved,and the classification of shortness of breath and airway stenosis were significantly improved(P<0.05).The incidence of secretion retention in silicone stent group was 75.6%(31/41),which had no significant difference in comparison with metal covered stent group(86.4%,38/44),P>0.05.However,the incidence of moderate secretion retention in metal covered stent group(31.8%,14/44)was higher than that in silicone stent group(10.3%,4/41),P<0.05.The incidence of granulation tissue in silicone stent group was 34.1%(14/41),lower than the 61.4%(27/44)in metal covered stent group(P<0.05),but there was no significant difference in the incidence of displacement between the two groups(P>0.05).Conclusions Silicone stent and metal stent placement both are fast,direct,safe and effective treatment methods of MCAO.Compared with patients with silicone stent,there are more moderate mucus retentions and granulation formation in patients with metal covered stent,therefore,more bronchoscopic intervention measures are needed.

关 键 词：支架 恶性中心气道狭窄 硅酮支架 金属覆膜支架 

分 类 号：R56[医药卫生—呼吸系统]