摘要
学术背景:气管内支架是目前治疗气道狭窄的重要手段。近年来,随着科学技术的发展,气管内支架的种类不断增多,性能也在不断扩展。根据气道病变的不同,所需内支架的性状和种类亦不同。目的:综述近年来国内外气管内支架的最新研究进展,以指导临床正确选择内支架的种类。检索策略:应用计算机检索www.highwire.org 2002-01/2007-11的相关文献,检索词"trachus,bronchus,stent",并限定文章语言种类为English。同时计算机检索中国期刊全文数据库www.cnki.net 2002-01/2007-11的相关文献,检索词"气管,支气管,支架",并限定文章语言种类为中文。文献评价:共检索到英文文献363篇,从中选出代表性文章36篇;中文文献101篇,从中选出代表性文章9篇。另有2本专著作为参考。资料综合:①根据材质,气管内支架可分为金属支架和非金属支架两种。根据有无被膜,又分为被膜支架和裸支架。②原则上各种原因引起的大气道狭窄或软化失去手术机会或其他治疗方法无效时,尤其是患者处于严重呼吸困难的急症时,均适用于内支架治疗。③良性气管狭窄患者主要放置可回收支架(Z型被膜支架)或硅酮支架,近期内可予取出,慎用Wallstent裸支架或Ultraflex裸支架。恶性病变,如生存期较长的患者首选放置Z型被膜支架,生存期较短的患者可用Ultraflex支架或Wallstent,慎用Gianturco支架。累及隆突的病变可选用"Y"型支架。气道内病变还可与热消融、冷冻等方法结合应用,良性病变慎放支架,恶性病变消融术后可放置放射性粒子支架,以防肿瘤复发。结论:气管内支架置入是一种快速、安全缓解良、恶性气道狭窄的治疗方法。
BACKGROUND： At present, tracheobronchial stent is an important approach in treatment of airway constriction. With the development of the scientific techniques, the tracheobronchial stent＇s type has been increased unceasingly, and its characteristics have also been extended. The differences of airway lesion may induce the different stent characteristics and types.
OBJECTIVE： To review the updates of tracheobronchial stents in China and abroad, and guide the clinicians to correctly choose the stents.
RETRIEVAL STRATEGY： A computer-based online search of www.highwire.org was undertaken for articles published in English between January 2002 and November 2007 with the key words of ＂trachus, bronchus, stent＂. Meanwhile, Chinese articles were searched on China Journal Full-text Database www.cnki.net with the same key words from January 2002 to November 2007. LITERATURE EVALUATION： A total of 363 English articles and 101 Chinese articles were collected, and 36 English and 9 Chinese accorded with the inclusive criterion, as well as 2 books.
DATA SYNTHESIS： （1）Based on the material, tracbeobronchial stents are generally of two types, metallic and non-metallic. According to the cover, stents are divided into covered stents and uncovered stent.（2）Sents are applied for the patients who miss the operation opportunity due to the main airway stenoses or trachomalaica, and who are ineffective by other treatments, in particular who are suffering from serous dyspnea.（3）The retrievable metallic （Z-type covered stents） or silicone stents are needed in benign stenoses patients, while Wallstent and Ultraflex stents are not permitted. Z-type covered stents are strongly recommended for the long life-span malignancies, while Wallstent and Ultraflex stents are suggested for short period of malignancies. For severe tracheobronchial stenoses involving the carinal bifurcation region, Y-shape stents are available. Therapeutic bronchoscopy with immediate effect, such as thermal ablation and cryosurgery recommended. Radioactive particle stents fit the malignant patients, for the prevention of tumor recurrence.
CONCLUSION： The tracheobronchial stents is a rapid and safe therapeutic method to relief symptoms of airway benign or malignant stenoses.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第9期1738-1744,共7页
Journal of Clinical Rehabilitative Tissue Engineering Research
