Tracheobronchial stenting in the terminal care of cancer patients with central airways obstruction
Tracheobronchial stenting in the terminal care of cancer patients with central airways obstruction
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DOI：
10.1378/chest.120.6.1811
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发表时间：
2001-12-01
期刊：
影响因子：
9.6
通讯作者：
Sutedja, TG
中科院分区：
文献类型：
--
作者：
Vonk-Noordegraaf, A;Postmus, PE;Sutedja, TG
研究目的：评价一组晚期癌症所致中央气道阻塞患者支架置入的姑息性获益。设计：回顾性分析支架置入后即刻患者的症状评分，并在患者在家死亡后由全科医生（GP）完成问卷调查。设置：学术医院，介入支气管镜三级转诊中心。患者和方法：14例因终末期食管癌（n = 5）和非小细胞肺癌（n = 9）引起的中心气道严重阻塞而即将窒息的患者被转诊接受支架植入术。所有假体均在入院后24 h内放置。然后询问患者他们的症状是否有所改善。在患者死亡后，向每位患者的GP发送了一份调查问卷。结果：所有患者均表示支架植入后立即受益。支架置入后的平均存活时间为11周（范围：0.5 - 34周）。2例患者在我院支架置入术后1周内死亡。在其余的12例患者中，GP认为支架植入7例患者是值得的，没有判断，在4例患者，支架植入1例被认为是futility.Conclusion：尽管终端疾病和事实，在我国，患者可以合法地拒绝任何治疗，并正式要求安乐死，支架植入术的姑息性的好处，应始终考虑。所有患者术后症状均立即缓解。在58%（12例患者中的7例）的病例中，负责家庭终末护理的全科医生仍然认为值得植入支架。支架置入术应始终被认为是治疗晚期癌症患者的一部分，濒临窒息。
Study objectives: To evaluate the palliative benefit of stent insertion in a group of patients with central airways obstruction due to terminal cancer.Design: Retrospective analysis of the symptomatic score of patients immediately after stent insertion, and questionnaires completed by the general practitioner (GP) after the patients died at home.Setting: Academic hospital, tertiary referral center for interventional bronchoscopy.Patients and methods: Fourteen patients with imminent suffocation due to major obstruction of the central airways, caused by end-stage esophageal cancer (n = 5) and non-small cell lung cancer (n = 9), were referred for stent insertion. All prostheses were placed within 24 h after hospital admittance. Patients were then asked whether their symptoms had improved. After the patients died, a questionnaire was sent to each patient's GP.Results: All patients expressed immediate benefit after stenting. The average length of survival after stent insertion was 11 weeks (range, 0.5 to 34 weeks). Two patients died within 1 week in our hospital after stent placement. In the remaining 12 patients, the GP considered stent insertion in 7 patients to be worthwhile, no judgment was made in 4 patients, and stent insertion in 1 patient was regarded as futile.Conclusion: Despite terminal disease and the fact that, in our country, patients may legally refuse any treatment and formally ask for euthanasia, the palliative benefit of stent placement should always be considered. All patients had immediate symptomatic relief afterwards. Retrospectively, the GPs responsible for terminal care at home still considered stent insertion worthwhile in 58% (7 of 12 patients) of cases. Stent placement should always be considered as part of the treatment of terminal cancer patients kith imminent suffocation.