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晚期肺癌患者采用硅酮支架置入术姑息治疗危及生命的咯血

Palliative treatment of life-threatening hemoptysis with silicone stent insertion in advanced lung cancer.

作者信息

Barisione Emanuela, Genova Carlo, Grosso Marco, Pasquali Mercedes, Blanco Alessandro, Felletti Raffaella, Salio Mario

机构信息

Pulmonology Unit, IRCCS San Martino Hospital IST.

出版信息

Monaldi Arch Chest Dis. 2017 May 18;87(1):781. doi: 10.4081/monaldi.2017.781.

Abstract

Massive hemoptysis is a stressful and life-threatening event that can occur in lung cancer patients. The management of this event is usually challenging, and can involve surgery, embolization, and bronchoscopy. Unfortunately, while surgery can offer a definitive solution to hemoptysis, lung cancer patients are often excluded from this approach. On the other hand, bronchial arterial embolization rarely results in long-term control of bleeding. Endoscopy allows a skilled physician to perform mechanical tamponade or laser photocoagulation of bleeding lesions and preserve the main airways. While endoscopic stent placement is usually performed in order to treat stenosis, it has been occasionally employed to isolate and mechanically block the bleeding sites within the bronchial tree. We present the cases of two patients suffering from lung cancer-related life-threatening hemoptysis; both patients were successfully treated by positioning a silicone stent during emergency bronchoscopy. Subsequently, we present a concise review of the available literature.

摘要

大量咯血是肺癌患者可能发生的一种压力巨大且危及生命的事件。对这一情况的处理通常具有挑战性,可能涉及手术、栓塞和支气管镜检查。不幸的是,虽然手术可为咯血提供确定性解决方案,但肺癌患者往往被排除在这种治疗方法之外。另一方面,支气管动脉栓塞很少能实现对出血的长期控制。内镜检查能让技术娴熟的医生对出血病变进行机械压迫或激光光凝,并保留主要气道。虽然内镜支架置入通常用于治疗狭窄,但偶尔也会用于隔离和机械性阻塞支气管树内的出血部位。我们介绍了两名患有与肺癌相关的危及生命咯血的患者病例;两名患者均在急诊支气管镜检查期间通过放置硅胶支架成功治愈。随后,我们对现有文献进行了简要综述。

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