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目的:探讨金属支架在成人非肿瘤性气管狭窄治疗中的可行性及疗效。方法:7例非肿瘤因素造成成人患者气管狭窄,除1例全喉术后气管瘘口段狭窄较小以外,其余6例气管狭窄长度均在4cm以上;因患者不能或不愿接受常规外科手术治疗,采用记忆性钛合金支架治疗;其中4例使用了无硅胶膜支架,3例使用了硅胶膜支架。结果:支架治疗的7例患者,术后梗阻症状缓解,除1例全喉术后患者外其余6例患者在术后均拔除了气管套管、关闭了气管瘘口,并恢复了正常的呼吸及发声功能;纤维喉镜随访检查显示大多数患者对支架耐受好,局部仅发生轻度炎性反应、肉芽增生,经处理后病情稳定;1例患者术后6个月因局部炎性反应、肉芽增生而再次狭窄,需再次气管切开;另1例患者因局部不适反应明显,于术后10个月拔除支架,随访检查未见再次狭窄。结论:金属支架治疗方法近期效果稳定,操作简便,不良反应少,尤其适合部分不能进行常规外科手术治疗的患者,中、远期疗效需进一步观察。
Objective: To investigate the feasibility and efficacy of metal stent in the treatment of adult non-tumor tracheal stenosis. Methods: Seven cases of tracheal stenosis caused by non-tumor factors in adult patients except for one case of throat after tracheal fistula stenosis was smaller than the other six cases of tracheal stenosis were more than 4cm in length; patients can not or do not want to accept conventional surgery Treatment, the use of memory titanium stent treatment; of which 4 cases without the use of silicone stent, 3 cases using a silica gel stent. Results: In the 7 cases treated with stents, the symptoms of postoperative obstruction were relieved. Except for one patient with complete laryngectomy, the remaining 6 patients were excluded from the tracheal tube after operation, the tracheal fistula was closed, and the normal respiration was resumed And vocal function; fiberoptic laryngoscopy follow-up examination showed that the majority of patients with stent tolerance is good, only local mild inflammatory reactions, granulation hyperplasia, stable after treatment; 1 patient 6 months after the local inflammatory response , Granulation hyperplasia and again stenosis, to be tracheotomy again; another case of local discomfort due to significant, 10 months after the removal of the stent, follow-up examination showed no further stenosis. Conclusion: The metal stent treatment has the advantages of stable effect, simple operation and few adverse reactions. It is especially suitable for some patients who can not be treated by conventional surgery. The curative effect of medium and long-term need further observation.