气道支架置入术在现代儿科介入呼吸病学的应用

Application of airway stenting in modern pediatric interventional respiratory diseases

随着肺部计算机断层扫描(CT)及支气管镜术在儿科的普及和发展,中心性气道狭窄越来越多地被诊断。中心性气道狭窄可影响肺通气功能及分泌物排出,患儿常因反复肺炎住院,重者需呼吸机辅助通气,还可能出现撤机困难,常合并营养不良、缺氧性脑损伤、生长发育落后等。以往中心性气道狭窄多采用外科手术治疗。近年来,随着呼吸内镜微创医学的发展,气道内支架置入成为一种有效的、可供选择的治疗方案。该文将对儿科中心性气道狭窄的类型、气道内支架置入的适应证和禁忌证、支架的种类和选择、支架置入术的工作流程等作一阐述。

With the popularization and development of lung CT scanning and technology of bronchoscopy in pediatrics,central airway obstruction has been diagnosed more and more.Central airway obstruction can affect airway ventilation and secretion discharge,such children are often hospitalized for repeated pneumonia,and sometimes need mechanical ventilation but may be difficult weaning from it. Malnutrition,hypoxic brain injury and backward growth and development are often associated. In the past,central airway obstruction has been mainly treated by surgery. However,with the development of minimally invasive technology of bronchoscopy in children,airway stent implantation has become an effective and alternative treatment recently. This article reviews the types of pediatric central airway obstruction,indications and contraindication of airway stent implantation,types and selection of stent,and the procedures of stent implantation.