Ultraflex Airway Stent for the Treatment of Tracheobronchial Stenosis Due to Lung Cancer

背景：肺癌引起的支氣管氣道狹窄若是無法開刀仍舊對醫護人員是一個富有挑戰性的難題。它會使得病人出現嚴重呼吸道阻塞的症狀，使得生活品質大大降低，本文將報告我們過去5個月來的初步治療經驗。材料與方法：我們分析從西元2005年5月至11月在台中中國醫藥大學附設醫院接受氣管介入性治療的病人。對於病人所施以的氣管介入性治療包括先使用OLYMPUS PSD-60電燒來切除掉導致支氣管氣道阻塞或是狹窄的腫瘤，之後在狹窄的部位再佐以Ultraflex (Boston Scientific; Natick, MA)氣管支架支撐。結果：從西元2005年5月至11月，總共有5位病人接受氣管介入性的治療，5位病人皆是男性，年齡從42歲至70歲，平均年齡為57.4歲，導致支氣管氣道狹窄的原因皆是由於肺部鱗狀上皮細胞癌，5位病人皆出現明顯呼吸道阻塞的症狀，5位病人中有l位接受氣管支架，而有3位接受支氣管支架，另外一位病人則接受二支支氣管支架，5位病人藉由氣管介入性治療包括電燒切除以及支架置放之後，臨床症狀明顯改善，同時在我們的病人中沒有嚴重的併發症例如氣道破裂或是無法控制出血的產生。結論：對於由於肺癌引起的支氣管氣道狹窄，儘管病人是屬於末期，我們仍舊應該考慮施以氣管介入性治療包括電燒以及支架的置放，因為此種治療可以使得病人的症狀立即改善，使得生活品質得以提升，是一種可以讓病人得到最佳利益的療法。

關鍵字

支氣管氣道狹窄；氣管介入性治療；電燒；支架

並列摘要

Background: Tracheobronchial stenosis due to inoperable lung cancer is a challenging problem, and usually presents worrisome symptoms. We report a recent 5-month experience with interventional bronchoscopy in this group of patients, and evaluate the benefit of this palliative therapy. Materials and Methods: From May to November 2005, 5 patients with tracheobronchial stenosis due to lung cancer received interventional bronchoscopy at China Medical University Hospital. We used OLYMPUS PSD-60 unipolar electrode endobronchial electrocautery to dissect tumor tissue which had induced trachobronchial stenosis. After debulking the endobronchial tumor, we used an Ultraflex stent (Boston Scientific; Natick, MA) to maintain airway patency. Results: The patients comprised 5 males, with ages ranging from 42 to 70 years, and a mean age of 57.4 years; all had squamous cell carcinoma of the lung with endobronchial metastasis causing intrinsic airway obstruction. They also suffered from progressive dyspnea and received interventional bronchoscopy with electrocautery and stents (1 tracheal stent in 1 patient and 5 bronchial stents in 4 patients-1 patient received 2 bronchial stents). All symptoms immediately improved after the interventional procedure. No serious complications such as bleeding or airway perforation were noted. Conclusions: Even for patients with a very poor prognosis at the terminal stage of lung cancer, electrocautery and a stent implant for tracheobronchial stenosis must always be considered as a worthwhile palliative therapy to provide immediate symptom relief of dyspnea.

並列關鍵字

tracheobronchial stenosis ； interventional bronchoscopy ； electrocautery ； ultraflex airway stent

國際替代計量

Ultraflex Airway Stent for the Treatment of Tracheobronchial Stenosis Due to Lung Cancer

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