Restenosis Analysis Of Metal-coated Stent Implantation In The Large Airway

Objective: To investigate the restenosis after the large airway metal-coated stent,and to evaluate the clinical efficacy and complications of the metal-coated stent.Methods: A total of 34 patients with large airway metal-coated stent treated in Dalian central hospital from 2014.12 to 2019.12 were selected for follow-up.There are 22 males and 12 females;aged between 22-78 years;basic diseases: 6 cases of hypertension,4 cases of diabetes,3 cases of hypertension with diabetes.According to different causes,they were divided into benign and malignant groups,including 14 cases in benign group and 20 cases in malignant group.Age,gender,etiology of airway stenosis,airway status,and underlying diseases were analyzed.Review bronchoscopy immediately,1 week,1 month,3 months,and 6 months after surgery to observe and evaluate the postoperative curative effect,the time of restenosis,the growth of granulation tissue near the distal stent,the complications,and the death.In this study,SPSS 23.0 statistical software was used to statistically analyze the data.The measurement data were expressed as mean ± standard deviation(x ± s).Comparisons before and after treatment were performed using paired sample t test,and comparisons of measurement data between groups were performed using independent sample t.Test,comparison of count data was performed using X2 test.P <0.05 was considered statistically significant.Results: 34 patients received a total of 40 metal-coated stents,17 of the common type,11 of the L type,5 of the Y type,5 of the straight type,and 2 metal-coated stents imported from Korea.Stenosis: 13 cases of simple tracheal stenosis,2 cases of left main bronchus stenosis,2 cases of right main bronchus stenosis,16 cases of trachea combined with left and right main bronchus stenosis,and 1 case of tracheoesophageal fistula.The difference between benign and malignant groups was statistically significant in terms of age(P <0.05),and there was no significant difference in gender and stenosis(P> 0.05).The scores of dyspnea and airway stenosis after metal stent implantation in the two groups were significantly lower than those before implantation(P <0.05).Patients in both groups had restenosis after stent placement.There was no significant difference in restenosis rate between the two groups,and the difference was not statistically significant.Both groups of metal-coated stents had different degrees of granulation tissue proliferation after implantation,and the incidence of granulation tissue proliferation at the distal end was higher than the proximal end in both groups.According to the degree of granulation tissue hyperplasia,the grade was scored.The benign group: 1.71 ± 0.73;the malignant group: 1.20 ± 0.52;the scores of the two groups were significantly different(P <0.05).Complications occurred in both groups.Benign group: 5 cases of stent displacement;8 cases of stent removal,2 cases were removed due to stent displacement,2 cases were removed due to airway occlusion due to significant proliferation of granulation tissue,and 1 case was due to patients It was taken out because of intolerance,3 cases were taken out due to clinical symptoms and obvious improvement under bronchoscopy;4 cases had retention of secretions;no cough and death cases.Malignant group: 1 case of stent displacement;1 case of stent cough;2 cases of stent removal,2cases were removed by patients who could not tolerate;5 cases of retention of secretions;4 cases of death,due to complications of malignant tumor Likely.Conclusion:1.Metal-coated stent is safe and effective in treating benign and malignant large airway stenosis,and there is no significant difference in the immediate improvement of patients' symptoms in the two groups;2.Patients with benign large airway stenosis have a higher degree of granulation tissue proliferation after stent implantation than patients with malignant large airway stenosis,and the incidence of distal end of the stent is high;3.Patients with benign large airway stenosis have a long survival time and a high incidence of complications.