论文部分内容阅读
目的探讨球囊扩张及支架置入在瘢痕性气道狭窄治疗中的作用及安全性。方法对26例不同原因引起的气管、主支气管瘢痕性狭窄或闭塞在支气管镜直视下施行了球囊扩张及镍钛记忆合金支架置入,观察了气促指数、血氧饱和度及肺部影像的变化,并随访了3~56个月。结果26例瘢痕性气道狭窄患者均施行了球囊扩张,共置入气道支架27个,球囊扩张及支架置入后气道内径由(3.2±1.7)mm扩大至(11.5±1.8)mm,(P<0.01)呼吸困难立即缓解,气促指数由(2.8±0.6)下降至(0.6±0.5),(P<0.01),血氧饱和度由(88±2)%提高至(92±1)%,(P<0.01)。术后气道肉芽组织增生4例(15.4%),经高频电凝后未再反复出现肉芽组织增生。瘢痕导致再狭窄1例(3.8%),需反复球囊扩张;并发气胸1例(3.8%),支架断裂1例(3.8%)。结论支气管镜直视下球囊扩张及支架置入对瘢痕性气道狭窄治疗效果确切,并发症少。
Objective To investigate the effect and safety of balloon dilatation and stenting in cicatricial airway stenosis. Methods Twenty-six tracheobronchial cerclag stenosis or occlusion caused by different causes were performed under bronchoscope with balloon dilatation and implantation of nickel-titanium memory alloy stent. The effects of breath index, oxygen saturation and pulmonary Changes in the image, and followed up for 3 to 56 months. Results Twenty - six patients with cicatricial airway stenosis underwent balloon dilatation. A total of 27 airway stents were implanted. After balloon dilation and stent implantation, the diameter of the airway was expanded from (3.2 ± 1.7) mm to (11.5 ± 1.8) mm, (P <0.01), dyspnea was relieved immediately, and the index of shortness of breath decreased from (2.8 ± 0.6) to (0.6 ± 0.5), (P <0.01) and the oxygen saturation increased from (88 ± 2)% to ± 1)%, (P <0.01). Postoperative airway granulation tissue hyperplasia in 4 cases (15.4%), no recurrence of granulation tissue hyperplasia after high frequency electrocoagulation. 1 case (3.8%) of restenosis caused by scars and repeated balloon dilatation; 1 case (3.8%) had pneumothorax and 1 case (3.8%) had stent fracture. Conclusions Bronchoscope under direct vision balloon dilatation and stent placement is effective in treating cicatricial airway stenosis with few complications.