电子支气管镜引导下支架置入术治疗恶性气道狭窄对血气指标气促症状及肺功能的影响

doi:10.3969/j.issn.1006-6233.2023.09.026

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摘要 目的: 观察电子支气管镜引导下支架置入术治疗恶性气道狭窄对血气指标、气促症状及肺功能的影响。方法: 选取本院120例恶性气道狭窄患者,均行电子支气管镜引导下支架置入术治疗,观察一次置入成功率、并发症情况及术后6个月生存情况,比较治疗前后血气指标[氧分压(PaO₂)、二氧化碳分压(PaCO₂)、血氧饱和度(SaO₂)]、气促分级、肺功能指标[1s用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)]、ECOG评分。结果: 一次置入成功率96.67%,术后3例患者痰血明显,9例患者痰带少量血丝,8例患者胸骨后产生轻微疼痛,予以对症处理后全部消失;治疗后所有患者呼吸困难得到明显改善,术后6个月死亡21例(17.5%),且均是因原发疾病死亡;治疗后PaO₂、SaO₂较治疗前明显升高(P<0.05),PaCO₂较治疗前明显降低(P<0.05);治疗后气促分级为0~Ⅱ级,明显优于治疗前(P<0.05);治疗后FEV1、FVC、PEF较治疗前明显升高(P<0.05);治疗后ECOG评分较治疗前明显降低(P<0.05)。结论: 电子支气管镜引导下支架置入术治疗恶性气道狭窄安全有效,可明显改善患者血气指标、气促症状及肺功能,具有重要应用价值。

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	罗钰坤
	刘新
	高李玉
	廖钦

关键词 ：恶性气道狭窄, 电子支气管镜, 支架, 血气分析, 气促, 肺功能

Abstract：Objective: To observe the effects of electronic bronchoscopy-guided stent placement on blood gas indexes, shortness of breath, and pulmonary function in patients with malignant airway stenosis. Methods: A total of 120 patients with malignant airway stenosis who were treated with electronic bronchoscopy-guided stent placement were included in this study. The success rate of one-time placement, complications and 6-month postoperative survival were observed. Blood gas indexes [partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂) and oxygen saturation (SaO₂)], classification of shortness of breath, pulmonary function indicators [forced expiratory volume in 1s (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF)], and ECOG score were compared before and after treatment. Results: The success rate of one-time placement was 96.67%. After operation, there were 3 patients with obvious bloody phlegm, 9 patients with a little blood in sputum, and 8 patients with mild substernal pain, which all disappeared after symptomatic treatment. After treatment, dyspnea in all patients was relieved significantly. 21 (17.5%) patients died from the primary disease in 6 months after operation. After treatment, PaO₂ and SaO₂ increased significantly (P<0.05), and PaCO₂ decreased significantly (P<0.05). Shortness of breath was significantly improved (P<0.05). FEV1, FVC and PEF increased significantly (P<0.05), and ECOG score decreased significantly (P<0.05). Conclusion: Electronic bronchoscopy-guided stent placement is safe and effective in the treatment of malignant airway stenosis. It can significantly improve blood gas indexes, shortness of breath and pulmonary function.

Key words： Malignant airway stenosis Electronic bronchoscopy Stent Blood gas analysis Shortness of breath Pulmonary function

基金资助:四川省基层卫生事业发展研究中心立项项目,(编号:SWFZ17-Y-24)

通讯作者: 廖钦

引用本文:

罗钰坤, 刘新, 高李玉, 廖钦. 电子支气管镜引导下支架置入术治疗恶性气道狭窄对血气指标气促症状及肺功能的影响[J]. 河北医学, 2023, 29(9): 1554-1558.
LUO Yukun, LIU Xin, GAO Liyu, et al. Effects of Electronic Bronchoscopy-Guided Stent Placement on Blood Gas Indexes Shortness of Breath and Pulmonary Function in Patients with Malignant Airway Stenosis. HeBei Med, 2023, 29(9): 1554-1558.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.09.026 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I9/1554

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