良性大气道狭窄的支气管镜介入治疗

Endoscopic treatment of benign central airway stenosis

目的介绍该院支气管镜下治疗良性大气道狭窄的临床经验。方法28例良性气道狭窄病例,根据狭窄的病变性质、部位和程度采取支气管镜下介入治疗方法,对治疗后疗效评价、肺功能改善和并发症以及综合治疗方法的采用进行分析。结果28例病人共进行支气管镜介入治疗72次。其中行高压球囊扩张治疗16例,病因中以气管、支气管内膜结核为主;高频电治疗8例,以气管切开后肉芽组织增生和腔内息肉、良性肿瘤为主;气道内支架置入9例,病因以气管切开后气管狭窄和复发性多软骨炎气道累及为主。部分病人合用了多种治疗方法。治疗后24例病人呼吸困难迅速缓解,部分病人肺功能明显改善。高频电治疗病例中大出血1例,球囊扩张治疗以轻度胸痛和少量出血为主。支架置入后1例出现明显肉芽增生,需要介入治疗。结论支气管镜下介入技术治疗良性气道狭窄可以迅速解除气道梗阻,呼吸困难迅速改善,肺功能改善明显,并发症较少。

[Objective] To describe our experience with interventional bronehoscopy in the treatment of benign central airway stenosis. [Methods] We reviewed patient records and bronehoscopie findings. Clinical data, techniques performed, improvements of pulmonary function data, complications and results were recorded, [Results] 28 patients were treated. A total of 72 therapeutic interventions were performed： 16 eases were performed with balkan dilatations, the majority cause is endobronchial tuberculosis. 8 cases treated with electrocauterizations for granulation tissue formation after postintubation and tracheal polypoid and benign tumor. 9 cases were inserted with stents to treat tracheal malacia with relapsing polychondritis and postintubation stenosis. [Conclusions] Interventional bronchoscopy is an effective technique to resolve severe obstructions of the benign central airways. Dyspnea improves immediately and pulmonary function data improves greatly. There is no significant morbidity.