George P J, Irving J D, Khaghani A, Dick R
Department of Thoracic Medicine, London Chest Hospital, England.
Cardiovasc Intervent Radiol. 1992 Nov-Dec;15(6):375-81. doi: 10.1007/BF02734121.
This paper reports our experience in treating localized airway obstruction with expandable metal stents. Nine patients were treated for malignant obstruction and 6 for benign obstruction. The main indications for treatment were imminent asphyxia, breathlessness and/or repeated chest infections. All but 2 patients had received other treatments before referral. Seven patients with malignant obstruction had extrinsically compressed airways and all derived a sustained symptomatic improvement. Two patients with recurrent tracheal obstruction caused by intraluminal tumor gained lasting relief with the use of a covered expandable metal stent. All 6 patients with benign strictures were improved, although 2 developed recurrent obstruction caused by granulation tissue growing within and beyond the stent. It is concluded that the expandable metal stent provides an effective and noninvasive method of relieving large airway obstruction. As the long-term tissue tolerance to this type of stent is not known, caution is advised in the management of benign strictures. In patients with malignant obstruction, however, the expandable metal stent would appear to have considerable potential as a palliative treatment.
本文报道了我们使用可扩张金属支架治疗局限性气道阻塞的经验。9例患者接受了恶性阻塞治疗，6例接受了良性阻塞治疗。主要治疗指征为即将窒息、呼吸困难和/或反复肺部感染。除2例患者外，所有患者在转诊前均接受过其他治疗。7例恶性阻塞患者气道受到外部压迫，所有患者症状均持续改善。2例因腔内肿瘤导致气管反复阻塞的患者使用覆膜可扩张金属支架后获得持久缓解。所有6例良性狭窄患者病情均有改善，尽管有2例因支架内及支架外肉芽组织生长导致反复阻塞。结论是，可扩张金属支架为缓解大气道阻塞提供了一种有效且无创的方法。由于对这类支架的长期组织耐受性尚不清楚，因此在处理良性狭窄时建议谨慎。然而，对于恶性阻塞患者，可扩张金属支架作为一种姑息治疗方法似乎具有相当大的潜力。
