Bodhey N K, Gupta A K, Neelakandhan K S, Neema P K, Kapilamoorthy T R, Purkayastha S, Thomas B, Krishnamoorthy T, Kesavadas C
Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Australas Radiol. 2007 Aug;51(4):351-7. doi: 10.1111/j.1440-1673.2007.01749.x.
The purpose of this study was to assess the safety and long-term efficacy of self-expandable stents in the treatment of benign tracheal stenosis. Nine patients (seven men) with tracheal stenosis (including one with fistula) of varied cause were treated by fluoroscopically guided balloon dilatation and stenting with self-expandable metallic stents. The procedure was carried out under topical spray in eight patients and under general anaesthesia in one patient. The patients were followed up for a period ranging between 13 and 60 months. In eight of the nine patients, satisfactory positioning of the stent was achieved at the first instance, with immediate relief of dyspnoea. One patient with innominate artery aneurysm died 16 days after the procedure because of renal failure. At 1 month of follow up, six out of eight (75%) of our live patients were without any respiratory embarrassment. This dyspnoea-free result reached almost 90% by the end of 1 year especially so in the fibrous strictures. Four out of the eight live patients (50%) had cough for 2 months and two (25%) had mild blood-tinged sputum treated by inhalation and mucolytic agents. Secondary intervention was required in one patient at 1 month because of recurrent symptoms. The patient with tracheo-oesophageal fistula required surgical intervention because of fracture of the stent. Fluoroscopically guided balloon dilatation and stenting of the tracheal stenosis is an effective non-surgical therapy resulting in cure of fibrous strictures and palliation in cases of malignancy.
本研究的目的是评估自膨式支架治疗良性气管狭窄的安全性和长期疗效。9例气管狭窄患者（7例男性）（包括1例合并瘘管者），病因各异，接受了在荧光透视引导下的球囊扩张及自膨式金属支架置入术。8例患者在局部喷雾麻醉下进行手术，1例患者在全身麻醉下进行手术。对患者进行了13至60个月的随访。9例患者中有8例在首次置入时支架定位满意，呼吸困难立即缓解。1例无名动脉瘤患者术后16天因肾衰竭死亡。在随访1个月时，8例存活患者中有6例（75%）无任何呼吸窘迫症状。到1年末，无呼吸困难的患者比例几乎达到90%，在纤维性狭窄患者中尤其如此。8例存活患者中有4例（50%）咳嗽持续2个月，2例（25%）有轻度痰中带血，经吸入治疗及黏液溶解剂治疗。1例患者在1个月时因症状复发需要二次干预。气管食管瘘患者因支架断裂需要手术干预。荧光透视引导下的气管狭窄球囊扩张及支架置入术是一种有效的非手术治疗方法，可治愈纤维性狭窄并缓解恶性肿瘤患者的症状。
