Kim H
Department of Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea.
Respirology. 1998 Dec;3(4):221-8. doi: 10.1111/j.1440-1843.1998.tb00126.x.
Stenosing airway disease is classified as intraluminal obstruction, extrinsic compression, and malacia by the anatomical site of the lesion. Stenting therapy is indicated for symptomatic relief of life-threatening dyspnea caused by the last two types. Airway stents are made with metal mesh and/or silicone rubber, and currently more than 20 kinds of stent are available. The metal stent (e.g. Gianturco stent, Wallstent) is easy to insert, may not need general anesthesia, and has wider internal lumen. Because it is very hard to reposition or remove, it is mainly used in malignant airway obstruction. Among many kinds of silicone stent, the Dumon stent is most widely used for benign and malignant airway stenoses, but general anesthesia and rigid bronchoscopy are needed for insertion. It can be removed when the stenosing airway disease subsides completely. In many clinical studies, most patients (85-90%) improved immediately after stenting, and procedure-related mortality is low (< 3%) in experienced centers. Stent displacement, mucus impaction, and granulation tissue formation are potential complications. Stenting is one of many effective therapeutic modalities for stenosing central airway disease. Careful patient selection, experiences, and continuous development of new technology will bring better results.
狭窄性气道疾病根据病变的解剖部位分为腔内阻塞、外部压迫和软化。支架治疗适用于缓解后两种类型引起的危及生命的呼吸困难症状。气道支架由金属网和/或硅橡胶制成，目前有20多种支架可供使用。金属支架（如Gianturco支架、Wallstent支架）易于插入，可能无需全身麻醉，且内腔较宽。由于其很难重新定位或取出，主要用于恶性气道阻塞。在多种硅酮支架中，Dumon支架最广泛用于良性和恶性气道狭窄，但插入时需要全身麻醉和硬质支气管镜检查。当狭窄性气道疾病完全消退时可以取出。在许多临床研究中，大多数患者（85%-90%）在置入支架后立即改善，在经验丰富的中心，与手术相关的死亡率较低（<3%）。支架移位、黏液嵌塞和肉芽组织形成是潜在的并发症。支架置入是治疗中央气道狭窄性疾病的众多有效治疗方式之一。仔细的患者选择、经验以及新技术的不断发展将带来更好的结果。
