气道金属覆膜支架治疗恶性食管气管瘘的近期疗效和影响术后生存时间的因素分析  

Influencing Factors of Short-Term Curative Effect and Survival Time of Patients with Malignant Tracheoesophageal Fistula Treated by Metal Coated Airway Sten.

作　　者：马升军[1] 刘泳[1] 沈奕播[1] 李一诗[2] Ma Shengjun;Liu Yong;Shen Yibo(Department of Respiratory and Critical Care Medicine,the Fourth People's Hospital of Zigong City,Zigong,Sichuan 643000,China.)

机构地区：[1]自贡市第四人民医院呼吸与危重症医学科,四川自贡643000 [2]重庆医科大学附属第一医院呼吸与危重症医学科,重庆400000

出　　处：《四川医学》2024年第10期1142-1145,共4页Sichuan Medical Journal

摘　　要：目的探讨气道金属覆膜支架治疗恶性食管气管瘘(MTEF)的近期疗效和术后影响生存时间的相关因素。方法回顾性分析42例MTEF行气道金属覆膜支架置入治疗患者的临床资料,评价治疗后的近期疗效和胸部影像学、炎症指标的变化,并分析支架置入治疗后影响患者生存时间的相关因素。结果42例MTEF患者气道金属覆膜支架治疗后较治疗前气促指数明显下降、KPS评分明显升高,炎症指标(白细胞计数、CRP、PCT)明显好转,胸部CT值评分明显下降,差异均有统计学意义(P<0.05)。支架治疗后患者的中位生存时间为4.42个月,经Cox回归分析显示,肿瘤分期为Ⅳ期、术前KPS评分<50分是影响MTEF患者术后生存时间的独立危险因素。结论气道金属覆膜支架治疗MTEF近期临床疗效确切,肿瘤分期为Ⅳ期、术前KPS评分<50分是影响患者术后生存时间的独立危险因素。Objective To investigate the short-term effect of metal coated airway stent in the treatment of malignant tracheoesophageal fistula(MTEF)and the related factors affecting the survival time.Methods Clinical data of 42 MTEF patients treated with metal coated airway stents were retrospectively analyzed to evaluate the short-term efficacy after treatment,changes of chest imaging and inflammatory indicators,and to analyze the related factors affecting the survival time of patients after stent implantation.Results After treatment with metal coated airway stent in 42 MTEF patients,dyspnea index were significantly decreased and KPS score were significantly increased,compared with those before treatment,inflammatory indicators(white blood cell count,CRP,PCT)were significantly improved,and the chest CT score was significantly decreased with statistical significance(P<0.05).The median survival time of patients after stent treatment was 4.42 months.Cox regression analysis showed that the tumor staging at stage IV and preoperative KPS score lower than 50 points were independent risk factors for postoperative survival of MTEF patients.Conclusion The recent clinical effect of metal coated airway stent on MTEF was good.The tumor staging at stage IV and preoperative KPS score lower than 50 points were independent risk factors affecting the postoperative survival time of patients.

关 键 词：恶性食管气管瘘 气管金属覆膜支架 近期疗效 生存时间 

分 类 号：R735.1[医药卫生—肿瘤]