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目的探讨经气管或食管置入覆膜支架封堵气管瘘的疗效。方法 13例气管瘘患者,男9例,女4例,年龄55～83岁,平均60.3岁,其中食管癌性狭窄伴气管瘘8例,食管癌术后胃吻合口伴气管瘘3例,食管癌术后胸腔胃气管隆突瘘1例,肺癌术后左主支气管残端胸膜瘘1例。根据原发病变的性质、狭窄范围、瘘口部位的不同,在数字减影血管造影(DSA)监视下经食管或气管途径置入个体化设计覆膜支架封堵瘘口。结果 10例经食管置入覆膜支架10枚,其中管状覆膜支架8枚,下端大喇叭口覆膜支架2枚;3例经气管置入覆膜支架4枚,其中管状覆膜支架2枚,倒“Y”型覆膜支架1枚,“子弹头”残端瘘支架1枚。所有患者呛咳、呼吸困难和憋喘等症状迅速缓解,碘水造影显示瘘口封堵完全,CT检查显示支架贴壁良好。结论经气管或食管置入个体化覆膜支架治疗气管瘘,能迅速封堵瘘口和解除临床症状,简单、安全,值得推广。
Objective To investigate the efficacy of tracheal or tracheal stent placement tracheal or esophageal stent placement. Methods Thirteen patients with tracheal fistula, 9 males and 4 females, aged 55-83 years, average 60.3 years old, including esophageal cancer stenosis with tracheal fistula in 8 cases, esophageal cancer anastomosis with tracheal fistula in 3 cases, 1 case of thoracic gastric tracheal fistula after operation, 1 case of left main bronchial stump fistula after operation of lung cancer. According to the nature of the primary lesion, the scope of the stenosis, and the different parts of the fistula, an individualized stent-graft is placed in the fistula through the esophageal or tracheal approach under digital subtraction angiography (DSA). Results Ten patients underwent transdermal esophageal stent implantation, of which 8 were covered with a tubular stent and 2 were covered with a large bell mouth at the lower end. Three of them were implanted with stents, two of which , Down “Y ” type stent graft 1, “bullet ” stump stent a stump. All patients coughed, dyspnea and wheezing and other symptoms quickly relieved, Iodine water fistula closure showed complete, CT examination showed good scaffold adherent. Conclusion Tracheal or esophageal stent implantation of personalized tracheal fistula, can quickly plug the fistula and relieve clinical symptoms, simple and safe, it is worth promoting.