Nd∶YAG激光治疗喉气管狭窄的临床分析

Analysis of Nd∶YAG Laser Therapy in the Treatment of Laryngeal and Upper Tracheal Stenosis

目的 探讨Nd∶YAG激光对喉气管狭窄的治疗效果。方法 2 6例喉狭窄患者中 ,全喉术后造口呈环形狭窄 11例 ,半喉术后声门狭窄 7例 ,喉前庭及颈段气管狭窄 8例 ;Ⅰ度呼吸困难 18例 ,Ⅱ度呼吸困难 8例。充分暴露病变部位 ,以Nd∶YAG激光切除粘连带、粘膜赘、肉芽组织及瘢痕。激光手术后 ,11例插入气管套管扩张 ,15例未行扩张。结果 激光术后 2 5例患者呼吸困难得到改善 ,其中 11例术后 3～ 6个月拔出扩张管 ,另 11例拔除气管套管。拔管后随访 6～12个月 ,未再发生狭窄 ,治愈率 84 6 % (2 2 2 6 )。结论 Nd∶YAG激光或并扩张手术是治疗喉气管狭窄、解除呼吸困难的有效方法。

Objective To review the methods and effects of endoscopic Nd∶YAG laser therapy in the treatment of laryngotracheal stenosis. Methods 26 patients with laryngotracheal stenosis were included in this group. Among them 18 cases were of grade I dyspnea and 8 cases grade II dypnea. According to the cocation, severity and involvement area of stenosis, endoscopic Nd∶YAG laser was employed to ablate adhesions, mucocele, granulation tissue and scar. Result Among 26 patients, 25 got rid of breathe with difficulty, 22 of them were decannulated. The effective rate was 84 6%(22/26). Conclusions Endoscopic Nd∶YAG laser therapy is an effective modality in the treatment of laryngotracheal stenosis.