【摘要】 目的　评价金属支架治疗良恶性气管支气管狭窄的价值。方法　对 14例良恶性气管狭窄在X线引导下置入金属支架。气管切开后瘢痕性狭窄 2例,环状软骨骨折 1例,食管癌、肺癌纵隔转移 7例,食管支架压迫气管 2例,食管癌放疗后气管软化 2例。结果　全部病例气管支架均成功置入。呼吸困难得到即刻缓解。1例良性狭窄在置入支架后25d肉芽组织增生而发生再狭窄,床旁急诊切开气管,取出支架。另 2例良性狭窄已分别随访了 40月和 60月。8例患者死亡,术后生存时间 1~14个月,平均 4 5个月。1例食管癌放疗后气管软化的患者已存活 41个月。结论　金属支架治疗良恶性气管狭窄是一种有价值的、充满前景的治疗手段。然而对于良性气管狭窄的治疗,仍有待长期随访和病例数的积累。更多还原

【Abstract】 Objective To determine the value of stent placement in the treatment of benign and malignant tracheobronchial obstruction. Methods Between September 1998 and July 2003, 17 metallic stents were placed in 14 patients guided by fluoroscopy under local anesthesia. Before implanation, conventional X ray tomographs and CT were obtained to evaluate the exact length and diameter of the stenoses. The clinical diagnosis was as follows:postoperative strictures ( n =2), airway collapse from cricoid cartilage fracture ( n =1), extrinsic compression by metastatic lymphonode ( n =7), compression by esophageal metallic stent ( n =2) and tracheomalacia from radiotheraphy ( n =2). Stents were placed within the left main bronchus ( n =2), right main bronchus ( n =1), trache ( n =14). Patients were assessed before and after the procedure clinically and radiographically. Results Stent placement was technically successful in all patient, with immediate relief of respiratory symptoms in 14 patients. Among the three benign cases, the stent was surgically removed at day 25 because of progressive occlusion of the lumen caused by granular tissue in 1 patient; the other 2 patients had been followed up 40 months and 5 years respectively. 8 patients died with a mean survial of 4 5 month (range, 1~14 months), and 1 patient with tracheomalacia was still alive 40 months after stent placement. Conclusion Stent placement as a palliative and therapeutic measure seems to be very promising both for benign and malignant tracheobronchial obstruction . However,it is necessary for those patients with benign tracheobronchial obstruction to receive long term follow up.更多还原