目的：探讨床旁纤维支气管镜辅助下，利用双乳胶管协助置入气管支架治疗急性重度恶性气道狭窄病人的临床疗效。方法对该院2004年1月-2013年7月，因突发或进行性呼吸困难就诊，床旁纤维支气管镜下采用双乳胶管辅助置入气管支架的23例急性重度恶性气道狭窄的病例进行回顾性分析。结果23例患者置入支架24枚（1例右主支气管内复发性恶性狭窄并中央气道外压性狭窄患者同期置入2枚支架），准确率100％，操作时间180～300 s，平均为（247．96±37．94）s，操作时间短，患者容易耐受，术中未出现大咯血、窒息等严重并发症；支架置入后围手术期和短期（≤30 d）有效率均为100％。随访2～6个月不等，随访结束后生存率为47．83％，并发症发生率21．74％，包括支架移位、肉芽过度增生甚至向腔内生长。结论床旁纤维支气管镜辅助下，采用双乳胶管协助急性重度恶性气道狭窄病人置入气管支架，安全准确、快速简单、疗效确切，近期和中期（≤6个月）无管腔再狭窄、支架碎裂等严重并发症；支架置入后需定期随访。%Objective To explore the clinical efficacy of the placement of tracheobronchial stents with help of fiberoptic bronchoscopy and double latex-tubes at the sickbed to treat the acute ,severe and malignant tracheobronchial stenosis .Methods For having a sudden or pro gressive difficulty in breathing ,23 patients with the acute , severe and malignant tracheobronchial stenosis admitted to hospital from January 2004 to July 2013 were stented in aid of self-made double latex-tubes as labels via fiberoptic bronchoscopy at the sickbed and retrospective analysis was made .Results Twenty-three patients were implanted with 24 stents successfully ( 1 patient who had a recurrent malignant stenosis in right main bronchus and a pressured stenosis in the central airway was placed with two stents at one time).The rate of accuracy was 100%.It cost 180~300 s on operation,averaging(247.96 ±37.94) s.The peri-operative and short-term(≤30days) efficiencies were 100%.After stenting,23 cases were followed up for 2 to 6 months.The survival rate was 47.83%, and the rate of complications was 21.74%,which included migration ,excessive granulation ,even proliferation into stent cavity .Conclu-sions It’s safe,accurate,quick and simple to implant stents by using double latex-tubes auxiliary via fiberoptic bronchoscopy to treat patients with acute ,severe and malignant airway stenosis .In these patients it is imperative that tracheobronchial stenting be considered for symptomatic relief and improvement of quality of life .At the same time,there are not severe complications like re-stenosis and frac-ture within 6 months.Therefore,patients should be followed up at a regular time after stenting .
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