摘要
目的探讨气管镜引导下经硬质气管镜鞘管放置硅酮支架及T型管治疗良性气管狭窄的临床疗效。方法选取河南省人民医院2015年9月至2016年10月收治的10例气管狭窄患者为研究对象。根据患者气管狭窄性质、程度及解剖结构,选取合适的硅酮支架及T型管,在电子支气管镜引导下插入硬质支气管鞘管,并进行支架及T型管置入。术后60 d内行气管镜动态监测支架位置及气管内分泌物、肉芽组织生长等情况;术前和术后30 d行血气分析,并采用卡氏(KPS)评分对患者生活质量进行评估。结果 6例患者置入硅酮支架,4例患者置入T型管。硅酮支架及T型管均一次性置入成功,10例患者置入硅酮支架或T型管后呼吸困难症状均即刻缓解。10例患者术后30 d氧分压和KPS评分均高于术前(t=-10. 585、-15. 476,P <0. 05)。术后60 d内支气管镜下观察,3例患者轻度气管内肉芽组织增生,2例支架移位,2例排痰困难,对症处理后好转。结论气管镜引导下经硬质气管镜鞘管放置硅酮支架及T型管治疗良性气管狭窄技术可行,操作安全,疗效可靠。
Objective To explore the efficacy of silicone stent and T tube in the treatment of benign airway stenosis under hard bronchoscopy sheath guided by bronchoscope.Methods Ten patients with benign airway stenosis in Henan Provincial People′s Hospital from September 2015 to October 2016 were selected.According to the nature,extent and anatomical structure of the airway stenosis,the appropriate silicone stent and T tube were selected.The patients were treated with silicone stent and T-tube under the guidance of the electronic bronchoscope by hard bronchoscopy sheath.The stent position,endotracheal secretions and granulation growth were dynamically monitored by endoscopic examination within 60 days after treatment.The arterial blood gas analysis was performed and the quality of life was evaluated by Karnofsky(KPS)score.Results In the ten patients,6 patients were placed with silicone stent,and 4 patients were implanted with T-tube.Silicone airway stent and T tube were placed successfully in 10 patients at one time,dyspnea were relieved immediately.The oxygen partial pressure and KPS score of 10 patients at 30 days after surgery were higher than those before surgery(t=-10.585,-15.476;P<0.05).Regular observation under bronchoscopy after surgery showed that,three patients had mild endotracheal granulation tissue hyperplasia,two patients had stent displacement,and two patients had difficulty in sputum discharge,which was improved after symptomatic treatment.Conclusion The silicone stent and T tube in the treatment of benign airway stenosis under hard bronchoscopy sheath guided by bronchoscope is feasible,safe and reliable.
作者
李晓
马芸
张晓菊
马利军
张茜茜
潘金兵
LI Xiao;MA Yun;ZHANG Xiao-ju;MA Li-jun;ZHANG Qian-qian;PAN Jin-bing(Department of Respiratory and Critical Care Medicine,Henan Provincial People′s Hospital,the People′s Hospital of Zhengzhou University,Zhengzhou 450003,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第2期143-146,共4页
Journal of Xinxiang Medical University
基金
河南省科技攻关计划项目(编号:132102310206)
关键词
硅酮支架
T型管
气管狭窄
硬质支气管镜
silicone stent
T tube
benign tracheal stenosis
hard bronchoscope
