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气管支架植入术治疗肿瘤所致急性气道狭窄

[Tracheal stent implantation for the treatment of tumor-induced acute airway stenosis].

作者信息

Ma Gang, Wang Dao-Fang, Su Quan-Guan, Lou Ning, Zhu Zi-Wei, Fu Jian-Hua, Xu Mei-Xi

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China.

出版信息

Ai Zheng. 2008 Aug;27(8):851-5.

PMID:18710620
Abstract

BACKGROUND & OBJECTIVE: Tumor-induced acute airway stenosis is a medical emergency. Metal airway stent implantation can relieve dyspnea of patients suffering from this symptom and provide time for their further treatment. This study was to investigate the clinical application, efficacy, and complication management of tracheal stent implantation for the treatment of tumor-induced acute airway stenosis.

METHODS

Nickel-titanium (Ni-Ti) alloy stent implantation was performed under the guidance of fiber-optic bronchoscopy in 52 patients with tumor-induced acute airway stenosis.

RESULTS

Stent implantation was successful in all 52 patients. Dyspnea in all patients was significantly relieved. Values of arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and Karnofsky performance status (KPS) changed from (7.74+/-0.99) kPa, (5.37+/-0.39) kPa, and (68.85+/-8.08) preoperatively to (11.12+/-0.61) kPa, (4.58+/-0.30) kPa, and (84.62+/-5.03) postoperatively (P<0.01). The three-year survival rate was higher in lymphoma group than in lung cancer or esophageal cancer group. Postoperative complications were properly managed in all cases after symptomatic treatments.

CONCLUSIONS

Tracheal stent implantation is an effective palliative treatment for acute dyspnea caused by local tumor compression or tumor invasion of large airways. It can rescue patients at risk for airway obstruction, improve the quality of life in terminal cancer patients, and provide further treatment opportunities for them.

摘要

背景与目的

肿瘤所致急性气道狭窄是一种医疗急症。金属气道支架植入可缓解有此症状患者的呼吸困难,并为其进一步治疗争取时间。本研究旨在探讨气管支架植入术治疗肿瘤所致急性气道狭窄的临床应用、疗效及并发症处理。

方法

对52例肿瘤所致急性气道狭窄患者在纤维支气管镜引导下植入镍钛合金支架。

结果

52例患者支架植入均成功。所有患者呼吸困难均明显缓解。动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)及卡氏功能状态评分(KPS)术前分别为(7.74±0.99)kPa、(5.37±0.39)kPa及(68.85±8.08),术后分别为(11.12±0.61)kPa、(4.58±0.30)kPa及(84.62±5.03)(P<0.01)。淋巴瘤组三年生存率高于肺癌或食管癌组。经对症治疗后,所有病例术后并发症均得到妥善处理。

结论

气管支架植入术是治疗因局部肿瘤压迫或肿瘤侵犯大气道所致急性呼吸困难的有效姑息治疗方法。它可挽救有气道梗阻风险的患者,提高晚期癌症患者的生活质量,并为他们提供进一步的治疗机会。

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