通气导管辅助下125I支架植入治疗恶性气道狭窄

目的探讨局部麻醉及通气导管辅助下~(125)I粒子气管支架治疗恶性气道狭窄的疗效。方法回顾性分析于我科接受~(125)I粒子气管支架植入术治疗的恶性气道狭窄患者180例。分析~(125)I气管支架植入前、后患者气促评级、血氧饱和度(SaO2)及呼吸频率,术后随访患者的~(125)I支架情况、临床症状及生存情况。结果 180例均成功接受~(125)I粒子气管支架植入术,共植入~(125)I支架180枚,其中筒状支架132枚、"Y"型支架34枚、"L"型支架14枚。术后患者呼吸困难症状均有显著缓解。本组患者SaO2由术前的(80.60±3.87)%提高至术后的(94.31±3.40)%,差异有统计学意义(t=-30.52,P0.01);呼吸频率由术前的(29.36±3.20)次/分改善至术后的(19.29±2.19)次/分,差异有统计学意义(t=35.09,P0.01)。术后随访3~13个月,6例患者出现~(125)I支架再狭窄;患者生存期为49~401天,平均(182±94)天,患者60天生存率的估计值为0.99,180天生存率的估计值为0.65。结论局部麻醉及通气导管辅助下~(125)I气管支架植入术治疗恶性气道狭窄是安全、有效的方法。

125I stent implantation in treatment of malignant tracheal stenosis with help of ventilation catheter

Objective To explore the clinical efficacy of ¹²⁵I stent implantation in treatment of malignant tracheal stenosis with the help of ventilation catheter under local anesthesia. Methods Totally 180 consecutive patients with malignant tracheal stenosis underwent ¹²⁵I airway stent implantation were analyzed retrospectively. The anhelation grade, oxygen saturation and respiratory rate before and after operation were recorded and analyzed. ¹²⁵I stent situation, clinical symptoms and survival situation were followed up after operation. Results The success rate of ¹²⁵I stent placement was 100% (180/180), and the stent type was tubular stent in 132 cases, Y-shaped stent in 34 cases, and L-shaped stent in 14 cases. Dyspnea was significantly relived in all patients. Oxygen saturation and respiratory rate improved from (80.60±3.87)% and (29.36±3.20)times/min before operation to (94.31±3.40)% and (19.29±2.19)times/min after operation (t=-30.52, 35.09, both P<0.01). Patients were followed up 3-13 mouth after operation, and stent restenosis were occurred in 6 patients. The lifetime was 49-401 days and the average lifetime was (182±94) days. The 60-day survival rate was 0.99 and the 180-day survival rate was 0.65. Conclusion ¹²⁵I stent implantation in treatment of malignant tracheal stenosis with the help of ventilation catheter under local anesthesia is a safe and effective method.