Clinical Research On Intervention Therapy Of Implanting Metallic Stents In Main Airway Disease

Background.The central airway is including the trachea,eminence,left principal bronchus right principal bronchus and the middle bronchus.These part of airway become constrictive or stenotic by external pressure possibly create the respiratory failure. Sometimes may cause the death.This is one of common diseases in the department of Respiration.The patients with stenotic central airway,have the serious shortness of breath,the presymptom of asphyxia and difficulty to do operation for airway stenosis can be treated by interventional therapy,meanwhile by the etiological treatment,in order to save the life and to relieve the symptom.In this research,we do a clinical analysis based on metal stents have been implanted under the guidance of flexible bronchoseopy for central airway stenosis in113 patients.By the investigation the procedure of implanting metallic stents for treatment the main airway stenosis resulting from malignant tumors is a safe and effective therapy, and implanting Y-shaped incorporated stents affords a new technology in treating complex airway stenosis..Therefore,by the study on the clinical research,we detect that after intervention therapy of implanting metallic stems in main airway stenosis,cough and breathlessness are palliated in varying degrees.Airway stems were placed succussesfully can instantaneous relieve symptoms,prolong patients lives and improve living quality, especially in malignant airway stenosis patients.Objective:To introduce the placement of stents for treatment main airway stenosis under direct visual monitoring through the flexible bronchoscopy,to investigate the feasibility and therapeutic effect of Y-shaped stems for complex main airway disease.Method:Depending on different cause and different stenosis locations 115 cases with main airway stenosis were placed various types of NI-TI stems including Y-shaped stents under direct visual monitoring through the flexible bronchoscopy,and some cases were then treated by balloon dilation or high-frequency fulgurize.Results:122 NI-TI stems were implanted in the 115 cases under the guidance of interventional flexible bronchoscopy and fluoroscopy,including 8 Y-shaped incorporated stems(6 coverd,2 uncoverd).The procedure was successful by one implanting in 113 patients other than two,in one case by implanting again after failure. Dyspnea was improved after operation in all cases.The symptoms of cough and short breathing disappeared in 3 bronchus-esophagus fistula cases and one thoracic -stomach fistula case.Stents in 112 cases were found dilating completely,adherenting well and no migration by chest X-ray and bronchoscopy on the three day after operation.Observe the all patients 2 months～78 months,therapy effect was oppositive.The majority of patients suffered from throat pain,14 trachea-stenosis cases suffered from Dysphagia in 7 days after operation,2 cases with covered stents were found pulmonary upper-lobe atelectasis,and one suffered from asphyxia because of large hemoptysis while implating stent,5 suffered from fever,2 cases by Y-shaped stents were found pneumothorax.Conclutions:The procedure of implanting metallic stents for treatment the main airway stenosis resulting from malignant tumors is a safe and effective therapy,and implanting Y-shaped incorporated stents affords a new technology in treating complex airway disease.Then balloon dilation is a better way than stenting for treating the benign airway disease.Positive attitude should be hold in therapy on primary cause of main airway stenosis.