中心气道狭窄的呼吸介入治疗策略

Strategies of pulmonary interventional therapy for central airway obstruction

呼吸介入治疗已成为绝大多数良性或恶性中心气道狭窄的首选治疗方式。其治疗策略的优化应基于中心气道狭窄的定性和定量,结合患者的临床状态进行综合评估。术者应熟悉各种介入治疗手段如硬质支气管镜、热消融、冷冻治疗、球囊扩张、气道支架、近距离放疗和光动力治疗的优缺点,并兼顾各种治疗手段的可及性及熟练程度。单一呼吸介入治疗手段很难对中心气道狭窄达到理想的治疗效果,往往需要多种方法同期或序贯分次联合应用。

Pulmonary interventional therapy has become the first-choice treatment method for most malignant or benign central airway stenosis,and the optimization of its treatment strategy should be based on qualitative and quantitative assessment of central airway stenosis,as well as comprehensive evaluation of patients'clinical status.the advantages and disadvantages of various interventional therapy methods such as rigid bronchoscopy,thermal ablation,cryotherapy,balloon dilation,airway stents,endoluminal brachytherapy and photodynamic therapy should be proficient,and the accessibility and proficiency of various treatment methods should be considered.It is difficult to achieve the ideal therapeutic effect with a single pulmonary interventional therapy method,and multiple methods are often required to be applied simultaneously or sequentially and fractionally.