Gutzeit A, Koch S, Meier U R, Zollikofer Ch
Department of Radiology, Kantonsspital Winterthur, Brauerstr. 15, 8401 Winterthur, Czech Republic.
Cardiovasc Intervent Radiol. 2008 Jul;31 Suppl 2:S149-52. doi: 10.1007/s00270-007-9124-4. Epub 2007 Jul 21.
A 58-year-old patient with recently diagnosed non-small cell bronchial carcinoma was referred to us with increasing shortness of breath and orthopnea by her family practitioner. To exclude the possibility of a pulmonary embolism, contrast medium-enhanced angio-CT of the thorax was performed. This showed a large mediastinal tumor, which, on the one hand, infiltrated and occluded the left upper lobe bronchus and, on the other, constricted the left pulmonary artery over a considerable part of its length. In view of the palliative situation and massively increasing dyspnea, balloon dilatation of the obstructed left pulmonary artery followed by stent placement was performed. This resulted in an immediate improvement of the symptoms. The originally strongly oxygen-dependent and heavily dyspneic patient could be relieved of the external supply of oxygen and was able to sleep normally without additional medication within 24 h. The patient was able ambulate freely within 2 days, with a markedly improved quality of life.
一名58岁的患者最近被诊断为非小细胞支气管癌，其家庭医生因其呼吸急促和端坐呼吸加重将其转诊至我院。为排除肺栓塞的可能性，进行了胸部对比剂增强血管CT检查。结果显示一个巨大的纵隔肿瘤，一方面，该肿瘤浸润并阻塞了左肺上叶支气管，另一方面，在相当长的一段长度上压迫左肺动脉。鉴于患者的姑息治疗情况以及呼吸困难大幅加重，对阻塞的左肺动脉进行了球囊扩张，随后置入了支架。这立即改善了症状。最初严重依赖氧气且呼吸困难严重的患者在24小时内无需额外用药就能摆脱外部氧气供应，并且能够正常入睡。患者在2天内能够自由行走，生活质量明显改善。
