摘要
目的：评价金属支架治疗恶性肿瘤引起的气管狭窄的可行性和疗效。方法：40例恶性肿瘤压迫或侵犯气管，引起气管狭窄和严重的呼吸困难，分别置入金属支架，23例患者进行了后续的化学治疗和放射治疗。结果：32例狭窄位于主气管，共置入支架33个；8例累及气管下段及隆突区，置入Y型支架。28例术后支架即刻100％充分扩张，12例术后即刻扩张到支架固有直径的40%～80％。1周后复查，支架100％充分展开。全部支架位置良好，没有发生支架移位情况。4例患者在术后2～4月间，出现支架上口断裂，于支架上口处再次置入1枚支架后症状好转。17例恶性肿瘤患者放置支架后未经任何治疗生存期为2～6个月，23例患者放置后配合放射治疗及化学治疗，生存期明显延长达6～15个月，单因素生存分析显示两组存在统计学差异（P=0.002）。结论：气管支架能缓解晚期恶性肿瘤引起的呼吸困难，改善生活质量。结合后续的放射治疗和化学治疗能进一步延长生存时间。
Abstract
Objective: To evaluate the feasibility and efficacy of metallic stent for malignant airway obstruction. Methods: Forty patients with airway obstruction and dyspnea caused by malignant carcinoma underwent metallic stents placement. Twenty-three patients underwent additional chemotherapy and radiotherapy. Results: Stenosis of 32 patients were located in the trachea, 33 metallic stents were placed. Stenosis of 8 patients were located in the inferior segment or bifurcation of trachea, Y-shaped metallic stents was placed in each of these patients. The stents expanded sufficiently in 28 patients after immediate placement, and in other 12 patients, stents expanded about 40% to 80%. All stents expanded sufficiently after a week and did not have displacement. The stent disruption happened in 4 patients after 2～4 months of placement, they underwent replacement of stent again. The survial time of 17 patients without any additional therapy was 2～6 months. For the 23 patients who had chemotherapy and radiotherapy, the life span was obviously extended as long as 6～15 months. Single-factor survival analysis of overall survival showed that there was statistical significance between the two groups(P=0.002). Conclusion: Metallic stents are useful for relieving respiratory distress and improving life quality in patients with malignant airway obstruction, additional chemotherapy and radiotherapy can further lengthen existence.
关键词
气管狭窄 /
肿瘤 /
支架 /
放射学 /
介入性
Key words
Tracheal stenosis /
Neoplasms /
Stents /
Radiology /
interventional
郑加贺;刘兆玉;卢再鸣;畅智慧;赵 健;郭启勇.
金属支架治疗气管恶性狭窄的临床应用[J]. 中国临床医学影像杂志. 2011, 22(2): 86-88
ZHENG Jia-he;LIU Zhao-yu;LU Zai-ming;CHANG Zhi-hui;ZHAO Jian;GUO Qi-yong.
The clinical value of metallic stents for malignant airway obstruction[J]. Journal of China Clinic Medical Imaging. 2011, 22(2): 86-88
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