[1]毕永华,伊梦飞,付培基,等.透视引导下气道瘘封堵覆膜金属内支架取出术的应用[J].郑州大学学报(医学版),2019,(05):650-653.[doi:10.13705/j.issn.1671-6825.2019.06.093]
 BI Yonghua,YIN Mengfei,FU Peiji,et al.Application of X-ray fluoroscopy-guided removal of covered metal stent for blocking airway fistulas[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(05):650-653.[doi:10.13705/j.issn.1671-6825.2019.06.093]
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透视引导下气道瘘封堵覆膜金属内支架取出术的应用()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年05期
页码:
650-653
栏目:
系列研究
出版日期:
2019-09-20

文章信息/Info

Title:
Application of X-ray fluoroscopy-guided removal of covered metal stent for blocking airway fistulas
作者:
毕永华伊梦飞付培基吴 刚任建庄路慧彬任克伟韩新巍
郑州大学第一附属医院放射介入科 郑州 450052
Author(s):
BI Yonghua YIN MengfeiFU PeijiWU GangREN JianzhuangLU HuibinREN KeweiHAN Xinwei
Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052
关键词:
气道内支架 气道瘘 X线透视引导 支架取出
Keywords:
airway stent airway fistula X-ray fluoroscopy guidance removal of stent
分类号:
R562
DOI:
10.13705/j.issn.1671-6825.2019.06.093
摘要:
目的:总结在X线透视引导下气道瘘封堵覆膜金属内支架取出术的应用效果。方法:85例患者共放置90枚气道覆膜金属内支架用于封堵气道瘘,在X线透视引导下取出支架,其中男72例,女13例,年龄15~81(54.9±12.3)岁。回顾患者临床资料,分析支架取出的适应证。结果:85例患者90枚支架,成功取出89枚,技术成功率98.9%; 仅1枚支架存在金属丝残留,经支气管镜成功取出; 支架取出操作时间为(19.0±8.6)min。取出原因:常规取出46例,支架移位11例,肉芽组织过度增生10例,气道瘘复发8例,支架不耐受6例,支架断裂4例,留置时间分别为97.5(76.5,123.0)、11.0(3.0,26.0)、119.5(90.8,219.8)、24.0(10.0,64.0)、5.5(2.3,10.3)和89.5(74.0,127.5)d。支架取出术的并发症有支架金属丝残留(1例)、气道黏膜撕裂伴大咯血(2例)、因气道再狭窄需再次置入支架(1例)、需要机械通气的呼吸困难(1例)、吸氧可缓解的呼吸困难(1例)。结论:在X线透视引导下取出用于封堵气道瘘的覆膜金属内支架安全、有效; 推荐支架取出的时间窗为置入后第31~90天。
Abstract:
Aim:To investigate the indications and complications of X-ray fluoroscopy-guided removal of covered metal stent for blocking airway fistulas.Method:A total of 85 patients(72 males and 13 females)with airway fistulas were treated with 90 covered metal stents,and the stents were removed under the guidance of X-ray fluoroscopy. The age of the patients was 15 to 81(54.9±12.3)years. The clinical data of the patients were reviewed and the indications and complications of stent removal were analyzed.Results:A total of 89 stents were successfully removed, and the technical successful rate was 98.9%. Only one stent with residual metal wires was removed by bronchoscope. The time of stent removal was(19.0 ±8.6)min. The reasons for removal were as follows: conventional removal in 46 cases, stent displacement in 11 cases, excessive granulation tissue hyperplasia in 10 cases, airway fistula recurrence in 8 cases, stent intolerance in 6 cases, stent rupture in 4 cases, and the retention time was 97.5(76.5,123.0), 11.0(3.0,26.0), 119.5(90.0,219.8), 24.0(10.0,64.0), 5.5(2.3,10.3)and 89.5(74.0,127.5)days, respectively. The complications of stent removal included residual metal wire(1 case), airway mucosal tear with massive hemoptysis(2 cases), re-stenting due to airway restenosis(1 case), and dyspnea requiring mechanical ventilation(1 case), dyspnea relieved by oxygen(1 case).Conclusion:X-ray fluoroscopic removal of airway stent for blocking airway fistulas is safe and effective. The recommended removal time window is 31 to 90 days after the stent implantation.

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备注/Memo

备注/Memo:
【基金项目】国家自然科学基金项目(81501569)
【作者简介】韩新巍,通信作者,男,1958年6月生,博士,主任医师,研究方向:各类疾病的介入治疗,E-mail:hanxinwei2006@163.com
更新日期/Last Update: 2019-09-20