透视下气管管状金属内支架取出45例的临床分析

发布时间：2018-04-12 12:16

本文选题：气管 + 管状　；参考：《介入放射学杂志》2017年01期

【摘要】：目的探讨X线透视下气管管状金属内支架取出的指征、安全性和可行性。方法 2010年1月至2014年12月对45例、45枚气管管状金属内支架置入后的患者进行气管支架取出治疗。45枚中覆膜支架36枚,裸支架9枚,覆膜支架和裸支架的平均置入时间各为(3.2±0.7)个月和(2.5±1.2)个月,支架取出前36枚覆膜支架中15枚两端伴有不同程度的肉芽组织增生,3枚支架断裂。9枚裸支架均伴有肉芽组织增生,其中5枚完全包埋与气管黏膜下,2枚支架出现断裂。结果 45枚支架成功取出41枚(成功率91.1%),其中覆膜支架成功取出34枚(94.4%,34/36),裸支架成功取出7枚(7/9)。成功取出支架的41例患者中4例出现大咯血,出血量平均100 ml;气管黏膜撕裂5例,支架取出后气管塌陷需立即置入气管支架1例,气管断裂而急症行外科缝合1例,无手术相关死亡病例。结论气管管状金属内支架取出的适应证包括支架出现断裂、局部肉芽或肿瘤组织过度增生致气管再狭窄,良性气管病变临时性气道支架置入以及患者无法耐受支架等。透视下取出气道管状金属内支架相对安全,创伤小,解决了支架长期置入的并发症。
[Abstract]:Objective to investigate the indication, safety and feasibility of removing trachea tube metal stent under X-ray fluoroscopy.Methods from January 2010 to December 2014, 45 patients with 45 tracheobronchial metal stents were treated with trachea stents, including 36 covered stents and 9 bare stents.Among them, 5 were completely embedded and 2 stents were ruptured under the trachea mucosa.Results 41 stents were successfully removed (the success rate was 91.1%), of which 34 stents were successfully removed from 94.4R / 34 / 36A, and 7 stents were successfully removed from the bare stents (7 / 9).Among the 41 cases successfully removed stents, 4 cases developed massive hemoptysis with an average bleeding volume of 100 ml, 5 cases had tracheal mucosal tear, 1 case needed to be inserted into tracheal stent immediately after stent removal, and 1 case underwent surgical suture for acute tracheal rupture.There were no operation-related deaths.Conclusion the indications for removal of metallic stents in trachea include rupture of stents, restenosis of trachea due to local granulation or excessive hyperplasia of tumor tissue, temporary placement of tracheal stents in benign tracheal lesions and intolerable stents in patients.It is relatively safe and less invasive to remove the tubular metal stent in the airway under fluoroscopy, which resolves the complications of long-term stent implantation.
【作者单位】：郑州大学第一附属医院介入科、郑州大学介入治疗研究所、河南省介入治疗与临床研究中心;
【基金】：国家高技术研究发展计划(863计划)项目(2015AA020301)
【分类号】：R56;R816.4

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