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局部麻醉下隆突通气辅助Y形支架置入术治疗复杂气管支气管狭窄患者的初步临床经验

Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex tracheobronchial stenosis: initial clinical experience.

作者信息

Fu Yu Fei, Wei Ning, Zhang Ke, Xu Hao

机构信息

Department of Interventional Radiology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, China.

出版信息

Diagn Interv Radiol. 2014 Jul-Aug;20(4):330-4. doi: 10.5152/dir.2014.13498.

Abstract

PURPOSE

We aimed to report our preliminary results of subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex lower tracheal-carinal-main bronchial complex stenosis.

MATERIALS AND METHODS

Seven consecutive patients with lower tracheal-carinal-main bronchial complex stenosis underwent Y-shaped stent insertion under local anesthesia. During the procedure, subcarinal ventilation was performed using a 4 F angiographic catheter, and stent insertion was performed under the protection of ventilation. Data on technical success, clinical outcome, and follow-up were collected and analyzed.

RESULTS

Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia was technically successful in all patients without any major procedure-related complications. Seven stents were inserted in seven patients. Respiratory function improved in all patients, with the Hugh-Jones classification of respiratory status improving from grade IV-V before stenting to grade I-II after stenting. During the follow-up, one patient experienced re-stenosis of the stent. Average survival time was 185.7 days (range, 96-285 days) after the stenting procedure.

CONCLUSION

Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia can be an effective, simple, and safe method for lower tracheal-carinal-main bronchial complex stenosis.

摘要

目的

我们旨在报告在局部麻醉下对患有复杂的下气管-隆突-主支气管复合狭窄患者进行隆突下通气辅助Y形支架置入的初步结果。

材料与方法

连续7例患有下气管-隆突-主支气管复合狭窄的患者在局部麻醉下接受Y形支架置入。在手术过程中,使用4F血管造影导管进行隆突下通气,并在通气保护下进行支架置入。收集并分析技术成功率、临床结果及随访数据。

结果

在局部麻醉下进行隆突下通气辅助Y形支架置入在所有患者中技术上均获成功,且无任何与手术相关的重大并发症。7例患者共置入7枚支架。所有患者的呼吸功能均有改善,呼吸状态的休-琼斯分级从支架置入前的IV-V级改善为支架置入后的I-II级。在随访期间,1例患者出现支架再狭窄。支架置入术后平均生存时间为185.7天(范围96 - 285天)。

结论

在局部麻醉下进行隆突下通气辅助Y形支架置入对于下气管-隆突-主支气管复合狭窄可能是一种有效、简单且安全的方法。

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