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[硅酮内置假体治疗气管支气管狭窄。首例12例该方法治疗患者的报告]

[Silicone endoprosthesis in the treatment of tracheobronchial stenosis. Report of the first 12 patients treated with this method].

作者信息

Bolliger C T, Probst R, Tschopp K, Solèr M, Elsasser S, Hoheisel G, Perruchoud A P

机构信息

Abteilung für Pneumologie, Universitätskliniken Basel.

出版信息

Schweiz Med Wochenschr. 1991 Sep 7;121(36):1283-8.

PMID:1925457
Abstract

Inoperable tracheobronchial stenoses are most often due to malignant disease. Apart from systemic therapy, various local treatment modalities such as laser resection, cryotherapy and endobronchial radiation therapy have been designed to maintain airway patency. Recently, various models of tracheobronchial stents (or endoprostheses) have been designed to maintain airway patency. They prevent recurring endobronchial tumor growth or progressive extrinsic compression of dilated airways. Silicone stents are highly suitable for this purpose. We treated 12 patients (11 males, 1 female, median age 68,5 years) suffering from bronchial carcinoma (6), esophageal carcinoma (4), metastatic colon carcinoma (1) and metastatic osteosarcoma (1). One stent per patient was inserted at the following sites: 6 in the right main bronchus, 4 in the trachea, 1 in the left main bronchus and 1 tracheobronchial left. We observed 2 complications: one obstruction of a bronchial stent by secretions which could be managed by fiberbronchoscopy and one short fire to a bronchial stent on repeat laser therapy. Rapid and lasting relief of dyspnea was observed in all patients. Our initial experience with a median follow-up of 2 months confirmed the easy insertion technique, the excellent effect and tolerance as well as the simple postoperative care of these silicone stents. Their use immediately after relief of a tracheobronchial obstruction by local means can be recommended.

摘要

无法手术的气管支气管狭窄最常见的原因是恶性疾病。除全身治疗外,还设计了各种局部治疗方法,如激光切除、冷冻治疗和支气管内放射治疗,以维持气道通畅。最近,设计了各种气管支气管支架(或内置假体)模型来维持气道通畅。它们可防止支气管内肿瘤复发或扩张气道的渐进性外部压迫。硅胶支架非常适合此目的。我们治疗了12例患者(11例男性,1例女性,中位年龄68.5岁),他们分别患有支气管癌(6例)、食管癌(4例)、转移性结肠癌(1例)和转移性骨肉瘤(1例)。每位患者在以下部位插入1个支架:右主支气管6个、气管4个、左主支气管1个和左气管支气管1个。我们观察到2例并发症:1例支气管支架被分泌物阻塞,可通过纤维支气管镜处理;1例在重复激光治疗时支气管支架发生短路。所有患者均观察到呼吸困难迅速且持久缓解。我们最初的经验,中位随访2个月,证实了这些硅胶支架插入技术简便、效果和耐受性良好以及术后护理简单。建议在通过局部手段解除气管支气管梗阻后立即使用它们。

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