内镜支气管支架置入术成功的临床案例

V. S. Panteleev, M. A. Nartaylakov, A. S. Safonov, Yu. V. Petrov, M. P. Pogorelova, T. A. Shagabutdinov
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摘要

介绍。在各种来源的狭窄中,恢复气管和支气管通畅的综合方法包括他们的内窥镜支架置入,这可以是暂时的,也可以是最大限度的连续的。材料和方法。本研究提出两例成功的内镜下肺大叶支气管支架置入呼吸衰竭缓解的临床病例。在第一个病例中,左下叶支气管被假主动脉瘤破裂造成的血肿从外部压迫。因此,首先支架置入动脉瘤,然后压迫支气管。在第二个病例中,右下叶支气管因肺转移而支架置入。在这两例中,支气管狭窄都伴有肺不张。结果和讨论。在这两种情况下,支架置入都能有效地恢复狭窄支气管的通畅和扩张肺部,从而使呼吸衰竭得以停止。第一例在支架置入3个月后发现其向外移位,但在进一步的动态观察中未发现支气管狭窄复发。第二例患者在支架植入后6个月的随访显示支架功能良好。结论。本文的临床病例表明,内镜下支架置入术治疗各种原因支气管狭窄患者呼吸衰竭的疗效和可靠性高,从而提高患者的生活质量。
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Clinical Cases of Successful Endoscopic Bronchial Stenting
Introduction . A comprehensive approach to restore the patency of the trachea and bronchi in stenoses of various origin consists in their endoscopic stenting, which can be both temporary and maximum continuous. Materials and methods . The study presents two clinical cases of successful endoscopic stenting of the lower lobar bronchi of the lungs with relief of respiratory failure. In the first case, the left inferior lobar bronchus was compressed from the outside by a hematoma from a ruptured false aortic aneurysm. Thus, the aneurysm was stented first, and the compressed bronchus — second. In the second case, the right inferior lobar bronchus was stented due to lung metastases. In both cases, bronchial stenosis was accompanied by pulmonary atelectasis. Results and discussion . In both cases, stenting was effective in restoring the patency of stenosed bronchi and expanding the lungs, which enabled respiratory failure to be stopped. In the first case, 3 months after the stenting, its outward migration was revealed, but no recurrence of bronchial narrowing was observed during further dynamic observation. In the second case, the follow-up of the patient for 6 months after stenting showed adequate functioning of the stent. Conclusion . The presented clinical cases demonstrate high efficacy and reliability of endoscopic stenting in bronchial stenoses of various origin to cope with the respiratory failure and thereby improve the quality of life.
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