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金属支架置入治疗恶性气道狭窄

Metallic stent placement for malignant airway stenosis.

作者信息

Tanigawa Noboru, Kariya Shuji, Komemushi Atsushi, Nakatani Miyuki, Yagi Rie, Sawada Satoshi

机构信息

Department of Radiology, Kansai Medical University, Hirakata Hospital, Osaka, Japan.

出版信息

Minim Invasive Ther Allied Technol. 2012 Mar;21(2):108-12. doi: 10.3109/13645706.2011.566272. Epub 2011 Mar 21.

Abstract

The purpose of this study was to evaluate the utility of metallic stents for treating central airway stenosis caused by malignant tumors. The subjects were 72 patients (16 women, 56 men; mean age, 61 years; age range, 28-87 years) treated with metallic stents for dyspnea due to tracheobronchial stenotic lesions caused by malignant tumors between May 1990 and August 2010. The underlying disorder was primary lung cancer in 42 patients, metastatic lung cancer in 29, and mediastinal tumor in one patient. In 69 of 72 patients (95.8%), dyspnea began to improve following completion of the procedure. The average Hugh-Jones classification score improved from 4.2 before stenting to 2.8 after stenting. The patients' average survival following stent placement was 3.6 months (two days-33 months). Thirteen lesions developed re-obstruction during follow-up. Of these 13 lesions, eight patients with dyspnea underwent re-interventions with metallic stent replacement and improved. Airway stent placement is an immediate and effective method of treatment for dyspnea caused by stenotic lesions of the central airway due to malignant tumor. It is effective for treating stenosis due to either tracheobronchial intraluminal tumor or extrinsic compression. Restenting is also useful to treat dyspnea caused by restenosis following stent placement.

摘要

本研究的目的是评估金属支架治疗恶性肿瘤所致中央气道狭窄的效用。研究对象为1990年5月至2010年8月期间因恶性肿瘤导致气管支气管狭窄性病变引起呼吸困难而接受金属支架治疗的72例患者(16例女性,56例男性;平均年龄61岁;年龄范围28 - 87岁)。基础疾病为原发性肺癌42例,转移性肺癌29例,纵隔肿瘤1例。72例患者中有69例(95.8%)在手术完成后呼吸困难开始改善。平均休 - 琼斯分级评分从支架置入前的4.2提高到置入后的2.8。患者支架置入后的平均生存期为3.6个月(2天 - 33个月)。13处病变在随访期间出现再狭窄。在这13处病变中,8例呼吸困难患者接受了金属支架置换再干预并好转。气道支架置入是治疗恶性肿瘤导致中央气道狭窄性病变引起呼吸困难的一种即时且有效的方法。它对治疗气管支气管腔内肿瘤或外部压迫所致的狭窄均有效。再次置入支架对治疗支架置入后再狭窄引起的呼吸困难也有用。

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