支气管胸膜瘘介入治疗的有效性和安全性分析
Interventional treatment of bronchopleural fistula:analysis of its efficacy and safety
李艳春 1李晓冰 2丁小龙 2殷美攀 2马耀臻 2李春霞 2韩新巍 2吴刚2
作者信息
- 1. 450052 河南洛阳 解放军联勤保障部队第九八九医院呼吸与危重症医学科
- 2. 郑州大学第一附属医院放射介入科
- 折叠
摘要
目的 探讨介入技术治疗支气管胸膜瘘(BPF)的有效性和安全性.方法 对172例确诊BPF患者进行持续负压引流(CNPD)或气道内支架封堵联合CNPD治疗,收集患者临床资料,统计分析其有效性、安全性.结果 介入治疗5～7d后患者肺炎严重度指数(PSI)评分显著下降,166例(96.5％)患者引流成功.介入治疗后1个月,患者肺容积显著增加.介入治疗中位临床愈合时间为9个月(95％CI=6.18～11.83).Cox比例风险模型多变量分析显示,诊断时间(HR=0.53,95％CI=0.38～0.74,P＜0.01)和瘘口大小(HR=0.74,95％CI=0.55～0.99,P=0.04)与临床愈合显著相关.结论 CNPD或气道内支架封堵联合CNPD治疗BPF具有操作精准、微创、安全、有效等优点,可快速改善患者症状,提高生活质量,延长生存期,值得临床推广应用.
Abstract
Objective To investigate the efficacy and safety of interventional therapy for bronchopleural fistula(BPF).Methods A total of 172 patients with confirmed BPF were treated with continuous negative pressure drainage(CNPD)and/or airway stent occlusion therapy.The clinical data were collected,and its effectiveness and safety were analyzed.Results In 5-7 days after interventional treatment,the pneumonia severity index(PSI)decreased significantly,and successful drainage was achieved in 166 patients(96.5％).One month after interventional therapy,the lung volume was remarkably increased.The median clinical healing time of interventional therapy was 9.0 months(95％CI=6.18-1 1.83).Multivariate analysis of the Cox proportional hazards model showed that the diagnosis time(HR=0.53,95％CI=0.38-0.74,P＜0.01)and fistula size(HR=0.74,95％CI=0.55-0.99,P=0.04)were significantly correlated with the clinical healing time.Conclusion For the treatment of BPF,CNPD and/or airway stent occlusion has several advantages such as accurate operation,minimally invasive,safe and effective.It can quickly improve the symptoms and quality of life,and prolong survival,therefore,it is worthy of clinical promotion and application.(J Intervent Radiol,2024,33:641-645)
关键词
肺癌/肺叶切除术/支气管胸膜瘘/支架/引流/介入放射学Key words
lung cancer/lobectomy/bronchopleural fistula/stent/drainage/interventional radiology引用本文复制引用
出版年
2024
NETL
NSTL
万方数据