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恶性淋巴瘤的临时性气管支气管支架置入术

Temporary tracheobronchial stenting in malignant lymphoma.

作者信息

Schmidt B, Massenkeil G, John M, Arnold R, Witt C

机构信息

Department of Internal Medicine I, Medical School Charité, Humboldt University, Berlin, Germany.

出版信息

Ann Thorac Surg. 1999 May;67(5):1448-50. doi: 10.1016/s0003-4975(99)00254-4.

Abstract

BACKGROUND

Temporary stenting is a new strategy in the treatment of malignant airway stenoses. Patients receive stents as primary palliation followed by tumor-specific therapy in order to reduce the stenosis and subsequently remove the stent.

METHODS

We investigated this strategy of temporary airway stenting in 5 consecutive patients with malignant lymphoma (Non-Hodgkin's lymphoma, n = 3; Hodgkin's lymphoma, n = 2) who presented with severe dyspnoea. Nine stents (six Strecker, three Dumon stents) were implanted into the trachea or main bronchi. After stenting, patients underwent tumor-specific therapy (chemotherapy, n = 4; percutaneous radiotherapy, n = 1).

RESULTS

Clinical improvement of dyspnoea and stridor was observed in each patient after stent implantation. In 4 patients (80%), stents could easily be removed after successful tumor-specific therapy, which led to reduction of stenosis after a mean interval of 26 days (14 to 52 days). One patient died during chemotherapy 6 days after stenting.

CONCLUSIONS

The results show that temporary stenting is a valuable strategy in chemo- and radiosensitive malignancies, as it ameliorates the patients' respiratory condition until tumor-specific therapy is effective, and prevents poststenotic complications. It integrates stent implantation in a multi-therapy concept.

摘要

背景

临时支架置入是治疗恶性气道狭窄的一种新策略。患者接受支架作为主要的姑息治疗,随后进行肿瘤特异性治疗,以减轻狭窄并随后取出支架。

方法

我们对5例因严重呼吸困难就诊的恶性淋巴瘤患者(非霍奇金淋巴瘤,3例;霍奇金淋巴瘤,2例)采用了这种临时气道支架置入策略。9个支架(6个施特雷克支架,3个杜蒙支架)被植入气管或主支气管。支架置入后,患者接受肿瘤特异性治疗(化疗,4例;经皮放疗,1例)。

结果

支架置入后,每位患者的呼吸困难和喘鸣症状均有临床改善。4例患者(80%)在成功进行肿瘤特异性治疗后,支架可轻松取出,平均间隔26天(14至52天)后狭窄减轻。1例患者在支架置入后6天化疗期间死亡。

结论

结果表明,临时支架置入在对化疗和放疗敏感的恶性肿瘤中是一种有价值的策略,因为它可改善患者的呼吸状况,直至肿瘤特异性治疗起效,并预防狭窄后并发症。它将支架置入整合到多治疗理念中。

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