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目的观察气管-主支气管分支型部分覆膜内支架植入治疗主支气管内膜结核瘢痕性狭窄后长期疗效和并发症。方法选择2003年4月至2007年1月郑州大学第一附属医院放射科17例有较完整的随访资料的主支气管内膜结核瘢痕性狭窄放置气管-主支气管分支型部分覆膜内支架患者,17例患者分别在支架取出后第1、6个月行视觉类比测试法(VAS)。其中14例分别于支架取出后第1、6个月门诊行胸部CT和支气管镜复查,电话随访与信访3例。结果17例均一次性植入支架成功并在25～90d内成功取出支架,随访6～50个月,1例患者在支架取出后7d发生再狭窄,经治疗后未再发生呼吸困难,其余患者均未再次出现呼吸困难。支架取出后第1、6个月,17例患者VAS均较术前有明显改善(P<0.05)。结论气管-主支气管分支型部分覆膜内支架植入治疗主支气管内膜结核瘢痕性狭窄,操作成功率高,远期疗效可靠。
Objective To observe the long-term effects and complications of tracheobronchial branches partial stent-graft in the treatment of cicatricial stenosis of the main bronchial tuberculosis. Methods From April 2003 to January 2007, Department of Radiology, the First Affiliated Hospital of Zhengzhou University, 17 patients with more complete follow-up data of main bronchial tuberculous cicatricial stenosis were placed in tracheobronchial branches partial stent graft, Seventeen patients underwent visual analogue test (VAS) at 1 and 6 months after stent removal. Among them, 14 cases underwent chest CT and bronchoscopy at the first and sixth month after the stent was removed, respectively. Three cases were followed up by phone and letters. Results All the 17 cases were successfully implanted stents and the stents were successfully removed within 25-90 days. The patients were followed up for 6-50 months. One patient underwent restenosis 7 days after stenting, and no further dyspnea occurred after treatment. The remaining patients No recurrence of dyspnea. VAS in 17 patients was significantly improved compared with that before operation (P <0.05) at the first and sixth month after stenting. Conclusion Tracheobronchial partial graft stent implantation in the treatment of cicatricial stenosis of the main bronchial tuberculoma, high success rate, reliable long-term effect.