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载紫杉醇聚乳酸-羟基乙酸共聚物涂层支架治疗良性瘢痕性气道狭窄

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis.

作者信息

Qiu Xiaojian, Liu Yan, Zhang Jie, Wang Ting, Wang Juan

机构信息

Department of Respiratory, Beijing Tiantan Hospital, Capital Medical University, No. 119 Southern 4th Ring Road West, Beijing 100070, China.

出版信息

J Clin Med. 2022 Jan 20;11(3):517. doi: 10.3390/jcm11030517.

Abstract

BACKGROUND

Airway stent implantation used in the treatment of benign cicatricial airway stenosis (BCAS) can lead to local granulation and scar formation, resulting in restenosis and treatment failure.

METHODS

We systematically investigated a paclitaxel-loaded PLGA-coating stent (PLPCS) and analyzed the safety and efficacy of the PLPCS in patients with BCAS. Patients were enrolled from four hospitals in China and observed for six months after implantation, by bronchoscopy performed weekly in the first month and monthly thereafter. The stent was removed immediately upon detection of granulation tissue proliferation, leading to immobility of the stent.

RESULTS

Granulation tissue was formed one week after stent implantation, most of which was located at the upper edge of the stent and the narrowest airway in the stent. All stents were removed in three months (mean: 6.51 + 4.67 weeks), with a curative outcome in one case and ineffective results in two. The remaining seven patients developed complications within three months, necessitating early stent removal. The main complication was granulation formation, resulting in difficulty in stent removal.

CONCLUSION

Although PLPCS showed beneficial effects in basic and animal experiments, it cannot prevent airway restenosis in actual practice, mainly due to granulation formation.

摘要

背景

气道支架植入术用于治疗良性瘢痕性气道狭窄(BCAS)可导致局部肉芽组织和瘢痕形成,从而导致再狭窄和治疗失败。

方法

我们系统地研究了一种载有紫杉醇的聚乳酸-羟基乙酸共聚物涂层支架(PLPCS),并分析了PLPCS在BCAS患者中的安全性和有效性。患者来自中国的四家医院,植入后观察六个月,第一个月每周进行一次支气管镜检查,此后每月进行一次。一旦检测到肉芽组织增生导致支架固定不动,立即取出支架。

结果

支架植入后一周形成肉芽组织,大部分位于支架上缘和支架内最狭窄的气道处。所有支架均在三个月内取出(平均:6.51 + 4.67周),其中1例治愈,2例无效。其余7例患者在三个月内出现并发症,需要早期取出支架。主要并发症是肉芽组织形成,导致支架取出困难。

结论

尽管PLPCS在基础和动物实验中显示出有益效果,但在实际应用中它无法预防气道再狭窄,主要原因是肉芽组织形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0fd/8836604/0836bc20125e/jcm-11-00517-g001.jpg

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