良性中心气道狭窄支气管镜介入治疗术后近远期再狭窄相关因素分析

Risk Factor Analysis on Short and Long-term Restenosis After Interventional Therapy Under Bronchoscope of Benign Central Airway Stenosis

目的探讨良性中心气道狭窄支气管镜介入治疗术后近远期再狭窄相关因素。方法对2011年2月~2015年2月我院收治的60例良性中心气道狭窄患者经支气管镜下介入治疗,治疗方式包括高频电刀、冷冻、球囊扩张、金属覆膜支架置入等。治疗后对患者的治疗时机、局部感染情况、治疗方法、气道狭窄病因、年龄、性别、基础疾病等情况进行分析,随访观察评估术后疗效、出现再狭窄的时间,探讨近远期再狭窄的危险因素。结果 Cox回归分析表明,患有基础疾病(高血压、糖尿病)、球囊扩张、支架置入、治疗时机不当(溃疡坏死增值阶段)、局部感染是良性气管狭窄支气管镜下腔内介入治疗术后近期再狭窄的相关危险因素,其对再狭窄影响的风险比(OR值)依次为6.715、2.197、5.820、6.914、5.345。支架置入和治疗时机不当(溃疡坏死增值阶段)是良性气管狭窄支气管镜下腔内介入治疗术后远期再狭窄的相关危险因素,其对再狭窄影响的风险比(OR值)分别为6.706,7.154。结论良性中心气道狭窄患者支气管镜下腔内介入治疗术后近期再狭窄的危险因素是基础疾病、球囊扩张、支架置入、局部感染、治疗时机不当,远期再狭窄危险因素是支架置入和治疗时机不当。

Objective To explore the factors related to restenosis after bronchoscopy in patients with benign central airway stenosis.Methods Follow-up 60 patients after endovascular interventional therapy under electronic bronchoscope with benign airway stenosis from February 2011 to February 2015 in Second Hospital Affiliated of Nanhua University.The treatment methods include high frequency electrotome,freezing,balloon dilatation,metal covered stent implantation.After the treatment,we analyzed the situation which included treatment time,patients with local infection and the treatment of airway stenosis,etiology,age,gender,underlying diseases,follow-up observation to evaluate the efficacy of postoperative,observe the time of restenosis,so as to explore the recent and long-term restenosis risk factors.Results Cox regression analysis showed that patients with underlying diseases （hypertension,diabetes）,balloon dilation,stent implantation,improper timing of treatment （ulcer necrosis stage,local infection was added） treatment of benign tracheal stenosis by interventional bronchoscopy after recent risk of restenosis risk factors,their risk on restenosis effect than （OR value） were 6.715,2.197,5.820,6.914,5.345.The timing of stent implantation and improper treatment （ulcer necrosis value stage） is related to the risk of restenosis and long-term factors treatment of benign tracheal stenosis after bronchoscopy,their risk of restenosis effect ratio （OR value） were 6.706,7.154.Conclusion The risk factors of short-term restenosis after endovascular interventional therapy under electronic bronchoscope in patients with benign airway stenosis are basic disease,improper balloon dilatation,stent implantation,postoperative infection,and improper treatment timing.While the risk factors of long-term restenosis are stent implantation and improper treatment timing.