[1]牛荣仿,韩新巍,吴 刚,等.Y形自膨式气道覆膜支架治疗食管癌切除术后胸腔胃-右主支气管瘘的疗效评估[J].郑州大学学报(医学版),2019,(05):667-671.[doi:10.13705/j.issn.1671-6825.2019.01.117]
 NIU Rongfang,HAN Xinwei,WU Gang,et al.Clinical efficacy of Y-type self-expandable metal airway covered stent for the treatment of thoracogastric-right main bronchial fistula[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(05):667-671.[doi:10.13705/j.issn.1671-6825.2019.01.117]
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Y形自膨式气道覆膜支架治疗食管癌切除术后胸腔胃-右主支气管瘘的疗效评估()
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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:
667-671
栏目:
系列研究
出版日期:
2019-09-20

文章信息/Info

Title:
Clinical efficacy of Y-type self-expandable metal airway covered stent for the treatment of thoracogastric-right main bronchial fistula
作者:
牛荣仿韩新巍吴 刚焦德超毕永华路慧彬任克伟尉泽鹏许琳慧陈建建
郑州大学第一附属医院放射介入科 郑州 450052
Author(s):
NIU Rongfang HAN Xinwei WU Gang JIAO Dechao BI Yonghua LU Huibin REN KeweiYU Zepeng XU Linhui CHEN Jianjian
Department of Interventional Radiology, the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052
关键词:
Y形自膨式金属支架 气道覆膜支架 胸腔胃-右主支气管瘘
Keywords:
Y-type self-expandable metal stent airway covered stent thoracogastric-right main bronchial fistula
分类号:
R735.1
DOI:
10.13705/j.issn.1671-6825.2019.01.117
摘要:
目的:评价Y形自膨式气道覆膜支架治疗食管癌切除术后胸腔胃-右主支气管瘘的疗效。方法:收集接受Y形自膨式气道覆膜支架治疗的35例胸腔胃-右主支气管瘘患者的临床资料,支架置入前和置入2周后采用MRC、KPS及PSQI量表评估患者呼吸困难程度、肿瘤患者功能状态等级和睡眠质量,并记录支架置入术后18个月内支架相关并发症发生情况及患者存活状况。结果:35例患者共置入67枚气道覆膜支架,管状支架1枚,大Y形支架34枚,小Y形支架32枚。1枚置入失败,技术成功率为98.5%(66/67)。支架置入前患者MRC、KPS、PSQI评分分别为(3.60±0.77)、(34.86±11.47)、(16.90±1.37),术后2周分别为(1.57±0.78)、(57.14±12.96)、(10.03±2.70),均较术前改善(P<0.001)。9(25.7%)例发生主要并发症,11(31.4%)例发生一般并发症,无大出血、气道破裂等致死性并发症发生。支架取出10(28.6%)例。支架置入术后1、6、18个月存活率分别为74.3%、34.3%、11.4%。结论:Y形自膨式气道覆膜支架可有效封堵瘘口,改善胸腔胃-右主支气管瘘患者的存活状态。
Abstract:
Aim:To evaluate the safety and clinical efficacy of Y-type airway covered self-expandable metal stent(SEMS)for the treatment of thoracogastric-right main bronchial fistula after esophagectomy.Methods:Clinical data of 35 patients treated with Y-type air covered SEMS placement for thoracogastric-right main bronchial fistulas were collected.MRC, KPS and PSQI were used to assess the degree of dyspnea, functional status of patients with tumors and sleep quality before and 2 weeks after stent implantation. The incidence of stent-related complications and survival status within 18 months after stent implantation were recorded.Results:A total of 67 airway covered stents were placed in 35 patients, including 1 tubular stent, 34 large Y-type stents and 32 small Y-type stents.Only one stent failed in placement,and technical success rate was up to 98.5%(66/67). The scores of MRC, KPS, PSQI before stent placement were(3.60±0.77),(34.86±11.47),(16.90±1.37), and 2 weeks after were(1.57 ±0.78),(57.14 ±12.96),(10.03 ±2.70),respectively,and the sores after stent placement were all improved compared with those before stent placement(P<0.001). Major complications occurred in 9(25.7%)patients, and 11(31.4%)patients with general complications, and there were no fatal complications of massive hemorrhage or airway perforation. Stents removal applied with 10(28.6%)patients. The survival rates of 1st, 6th and 18th month after the surgery were 74.3%, 34.3% and 11.4%, respectively.Conclusion:Y-type airway covered SEMS can effectively seal the fistula and improve the survival status of patients with thoracogastric-right main bronchial fistula.

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备注/Memo

备注/Memo:
【基金项目】国家高新技术研究发展计划(863计划)项目(2015AA020301)
【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