摘要
目的比较金属和硅酮气道支架引起支架相关呼吸道感染(SARTI)的发生率以及病原学差异。方法中央型气道狭窄患者置入两种不同类型的支架:金属覆膜支架和硅酮支架。对支架置入后发生的"支架相关呼吸道感染"的发生率差异和病原学特点进行比较。结果 1)本组171例患者中,有39例患者(22.81%)发生支架相关呼吸道感染;2)金属支架组SARTI发生率为29.21%(26/89),显著高于硅酮支架组15.85%(13/82)(P<0.05);3)SARTI病原学差异:金属支架组和硅酮支架组的金黄色葡萄球菌感染率分别为38.46%和69.23%,白色念珠菌分别为23.08%和0%,奇异变形杆菌感染分别为7.26%和0%;4)改善管腔狭窄程度,金属支架组从74.27%±7.13%改善到治疗后17.64%±6.22%,硅酮支架组从74.94%±9.18%改善到治疗后12.68%±8.32%(P<0.01);与之相应,金属支架组的气促评分从2.85±0.89降至治疗后0.85±0.68,硅酮支架组从2.88±0.91降至治疗后0±0.61(P<0.05)。结论和金属支架相比,硅酮支架引起的SARTI发生率更低,这可能和硅酮支架表面有钉突以及更好扩张狭窄气道有关。
Objective To investigate the incidence and bacterial etiology of stent associated respiratory tract infection（ SARTI） caused by two types of airway stents. Methods Silicone and coated metal airway stent were placed into patients with central airway stenosis caused by varied pathologies. The incidence of stent related respiratory tract infection,bacteria etiology of SARTI and improved dyspnea score were compared between two groups receiving different airway stent. Results 1） Totally 171 patients received airway stents,and among them,39 patients（ 22. 81%） developed SARTI. 2） The incidence of SARTI in metal stent group and silicone stent group was 29. 21%（ 26/89） vs. 15. 85%（ 13/82）,P0. 05; 3） Bacterial spectrum of SARTI was different in metal and silicone stent groups： staphylococcus aureus was 38. 46% vs. 69. 23%,respectively; candida albicans was 23. 08% vs. 0%,respectively; Singular proteus was 7. 26% vs. 0%,respectively; 4） The narrowed lumen was improved from 74. 27% ±7. 13% to 17. 64% ±6. 22%in the metal stent group,while the data was improved from 74. 94%±9. 18% to 12. 68%±8. 32% in the silicone stent group（ P〈0. 01）. Accordingly,the dyspnea symptomscore was improvedfrom 2. 85 ±0. 89 to 0. 85±0. 68 in metal stent group,and from 2. 88±0. 91 to 0±0. 61 in the silicone stent group（ P0. 05）.Conclusions Compared with metal airway stents,silicone stents have a lower incidence of SARTI,which mightbe due to the projections in the silicon stent surface and wider expanded in the bronchial stenosis.
出处
《基础医学与临床》
CSCD
2018年第3期385-389,共5页
Basic and Clinical Medicine
关键词
支架相关呼吸道感染
金属支架
硅酮支架
气道狭窄
stent associated respiratory tractinfection （SARTI）
metal stent
silicone stent
airway stenosis
