摘要
目的探讨不同规格的金属内支架治疗严重气管狭窄和胸腔胃-气道瘘及肺叶切除术后支气管残端瘘的疗效。方法根据影像资料显示气管、支气管狭窄段位置、长度,瘘口位置、大小、范围及程度,设计镍钛记忆合金丝编织型管状裸支架或覆膜支架,治疗气管狭窄26例;气管-支气管分叉状裸支架治疗气管-支气管复合狭窄8例;气管-支气管分叉状覆膜支架治疗胸腔胃-右支气管瘘5例,支气管残端瘘4例。支架均在DSA监视下经口腔置入病变部位。结果43例共用镍钛记忆合金网状管状裸支架24枚,覆膜支架7枚(5例支架置入后再狭窄,重新置入覆膜支架)。17枚气管-支气管分叉型支架,其中9枚覆膜。支架置入后呼吸困难、憋喘及呛咳等症状即刻缓解,碘水造影显示瘘口完全封堵,无对比剂溢出。症状改善率为100%。结论依据影像资料选择记忆合金网状内支架治疗严重气管狭窄、胸腔胃鄄气道瘘、支气管残端瘘,能迅即解除呼吸困难和封堵瘘口,疗效可靠,值得临床推广应用。
Objective To study the effects of metal endo stents with memory alloy lattices＇ supporting of different dimensions in treating severe bronchial stenosis thoraco-stomach-airway fistula and bronchial remnant fistula after lobectomy. Methods N-T memory alloy lattice bare or membrana tectoria stents were designed based on the original dimensions and sites of the fistula and then were inserted though bronchoscopy to the sites of lesions under DSA monitoring simultaneously, including 26 cases of tracheal stenosis, 8 cases of tracheobronchial stenosis, 5 cases of thoraco-stomach-right bronchial fistula and 4 cases of bronchial semnant fistula. Results Altogether 43 cases used N-T memory alloy lattice tubular bare stents 24, N-T memory alloy lattice tubular covered stents 7, trachea-bronchial bifurcation embranchment stents 17, and covered stents 5. After implantation of the stents, the symptoms of dyspnea, heavy suppression of breath and chokes coughs, etc. were instantly alleviated, with improvement rate of 100%. The idodine water radiography demonstrated the fistulas were closed immediately, without any extravasation. Conclusions Memory alloy lattice endostenting could be used successfully to treat severe bronchial stenosis, thoracostomach-carina fistula, bronchial remnant fistula, with instanteneous relief of sympotoms and closure of the fistula. The procedure is safe and efficient, worthy to be recommanded. （J Intervent Radiol, 2007, 16： 390-393）
出处
《介入放射学杂志》
CSCD
2007年第6期390-393,共4页
Journal of Interventional Radiology
关键词
气道
狭窄
胸腔胃
主支气管瘘
内支架
Tracheal stenosis
Thoracostomach
Main bronchus fistula
Bronchial remnant end fistula
Stent
