摘要
目的 研究和分析气管内支架置入及鼻肠管置入或经皮胃造瘘术联合甲状腺动脉栓塞治疗甲状腺癌致气道及食管狭窄的安全性及有效性。方法 搜集2016年6月至2024年11月在本院就诊的12例甲状腺癌致气道和食管狭窄的患者,其中男5例,女7例。年龄68~84岁,平均76.8岁。所有患者均在全麻和CT血管造影术(DSA)引导下置入气管支架,并进行留置鼻空肠管或经皮胃造瘘术,随后行甲状腺动脉微球化疗栓塞治疗。结果 共置入直筒气管支架12枚,所有患者的呼吸困难均即刻明显缓解,气促指数由术前的3.26下降至术后的1.42、KPS评分由术前的40.23升至术后的68.85(P<0.001);气管狭窄度由治疗前平均约82%降低到治疗后的42%(P<0.001);置入鼻空肠管9例,行经皮胃造瘘3例,所有患者半月后营养状况明显改善;所有患者至少完成甲状腺肿瘤供血动脉栓塞1次,最大肿瘤截面由术前平均36 cm^(2)缩小至24 cm^(2)(P=0.008),随访6个月发现患者的呼吸通畅,无明显再发吞咽困难。结论 气管内支架置入结合鼻空肠管置入或经皮胃造瘘术联合甲状腺动脉栓塞治疗甲状腺癌致气道狭窄并食管狭窄是一种安全、有效的治疗方法。
Objective To study and analyze the safety and efficacy of endotracheal stent placement and nasointestinal tube placement or percutaneous gastrostomy combined with thyroid artery embolization in the treatment of airway and esophageal stenosis caused by thyroid cancer.Methods From June 2016 to November 2024,12 patients with airway com-bined with esophageal stenosis caused by thyroid cancer were collected,including 5 males and 7 females.The age ranged from 68 to 84 years with a mean of 76.8 years.In all patients,tracheal stents were placed under general anesthesia and DSA guidance,and intranasal jejunal tube or percutaneous gastrostomy was placed,followed by thyroid artery microsphere che-moembolization.Results A total of 12 straight tube tracheal stents were implanted.Dyspnea was immediately relieved in all patients.The shortness of breath index decreased from 3.26 to 1.42,and the KPS score increased from 40.23 to 68.85(P<0.001).Tracheal stenosis decreased from 82%before treatment to 42%after treatment(P<0.001).Nasal jejunal tube was inserted in 9 cases and percutaneous gastrostomy was performed in 3 cases.Embolization of thyroid tumor supplying arter-ies was completed at least once in all patients,and the maximum tumor cross section was reduced from the preoperative av-erage of 36cm2 to 24cm2(P=0.008).The patients had smooth breathing and no obvious recurrence of dysphagia after 6 months of follow-up.Conclusion Endotracheal stent implantation combined with nasojejunal tube implantation or percu-taneous gastrostomy combined with thyroid artery embolization is a safe and effective method for the treatment of airway ste-nosis and esophageal stenosis caused by thyroid cancer.
作者
赵纯
曾俊仁
徐松
蔡学光
代洪妍
周芸
赵娟娟
ZHAO Chun;ZENG Junren;XU Song(Radiology department,Affiliated Hospital of Yunnan University,Kunming,Yunnan Province 650021,P.R.China)
出处
《临床放射学杂志》
北大核心
2025年第10期1964-1968,共5页
Journal of Clinical Radiology
关键词
甲状腺癌
气道狭窄
食管狭窄
介入治疗
Thyroid cancer
Airway stenosis
Esophageal stenosis
Interventional therapy
