气道重度狭窄:介入放射学钳夹活检技术探讨

目的探讨气道重度狭窄行介入放射学钳夹活检的可行性、安全性和优越性。方法选取2006年10月至2011年9月气道重度狭窄、不能耐受纤维支气管镜检查的患者24例,行胸部MSCT以明确狭窄部位及程度,其中严重狭窄位于气管者14例,隆突2例,左主支气管6例,右主支气管2例;DSA下以介入放射学技术经口腔依次向气道引入导丝、导管,并交换引入鞘管,经鞘管引入内镜活检钳对气道狭窄区钳夹活检病理检查。结果气道狭窄区钳夹活检技术成功率100%,能获取满足病理要求的标本,未出现气道出血、穿孔、纵隔气肿、窒息、气胸等并发症。结论 DSA导向下介入放射学钳夹活检是急诊气道支架置入前明确病理学性质或纤维支气管镜活检失败者的可行替代技术,操作简单、安全,阳性率高。

Study of Forceps Biopsy By Interventional Radiology in the Severe Airway Stenosis

Objective To evaluate the feasibility,security and superiority of forceps biopsy of interventional radiology in severe airway stenosis.Methods 24 cases with airway stenosis were elected for forceps biopsy from October 2006 to September 2011.The chest MSCT was performed to show the position and degree of stenosis.Airway stenosis located at trachea in 14 cases,tracheal carina in 2,left principal bronchus in 6 and at right principal bronchus in 2.The forceps biopsy of interventional radiology was performed at the stenosed area guided by DSA,and then the specimens were analyzed pathologically.Results The technical success rate of forceps biopsy was 100%.Dyspnea relieved immediately after successful stents placement.No serious complications such as tracheorrhagia,perforate,mediastinal emphysema and asphyxia occurred.Conclusion The airway forceps biopsy of interventional radiology is an easy and safe method,which can be used as an alternative technique for patients who can not accept bronchofiberscope biopsy.