局部注射曲安奈德结合常规介入方法治疗难治性良性中央气道狭窄疗效及安全性的初步探讨  

Intralesional triamcinolone acetonide injection combined with conventional interventional modalities for the management of recalcitrant benign central airway stenosis ： preliminary experience

作　　者：陈愉[1] 伍惠仪[1] 李时悦[1] 

机构地区：[1]呼吸疾病国家重点实验室广州医学院第一附属医院广州呼吸疾病研究所,510120

出　　处：《中华结核和呼吸杂志》2012年第6期415-418,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的初步探讨在狭窄部位局部注射曲安奈德治疗难治性中央气道狭窄的疗效和安全性。方法2008年1月至2010年12月广州医学院第一附属医院就诊的难治性良性中央气道狭窄患者20例，其中男10例，女10例，年龄（40±16）岁，给予常规介入方法结合局部注射曲安奈德治疗；同期纳入常规介入方法治疗的20例难治性气道狭窄患者作为对照，其中男7例，女13例，年龄（36±17）岁。比较2组患者的疗效和安全性，随访6—18个月观察远期疗效。结果2组患者治疗后气道直径、横截面狭窄率、气促指数均明显改善，两组近期疗效没有明显区别（P〉0．05）；曲安奈德治疗组再狭窄的治疗间隔时间由术前的（11±5）d增加到术后的（99±56）d，20例中16例病情稳定，4例发生再狭窄需再次治疗。对照组再狭窄的治疗间隔时间为（11±4）d，两组比较差异有统计学意义（P〈0．01）。治疗组治疗前后血浆皮质醇及空腹血糖水平均在正常范围，无明显波动，未出现糖皮质激素局部注射的相关并发症。结论局部注射曲安奈德联合常规呼吸介入方法，可明显延长难治性良性中央气道狭窄再狭窄的时间，安全性较高。Objective To evaluate the efficacy and security of local injection of triamcinolone acetonide （TA） combined multiple convention interventional procedures for benign central airway stenosis （BAS） . Methods Forty patients with intractable benign central airway restenosis after treated by repeatedly traditional interventional treatment in our hospital between January 2008 to December 2010 were retrospectively analyzed. Forty intractable BAS patients were selected and averagely divided into treatment group and control group. Local injection of TA was uesd to cover entire stenosis lesions. Two or more procedures were combined to manage complicated airway stenosis. After a 6 months follow-up, compared to before and after the treatment of airway diameter, airway stricture rate, dyspnea score, interphase of interventional treatment and clinical stabilization, fasting blood glucose, plasma cortisol, injection local mucosal and clinical symptoms, evaluated its curative effect and side effect. Result Twenty cases of treatment group patients with intractable benign central airway stenosis were treated. After 6 to 18 months follow-up, 16 patients remain stable after treatment, besides 4 patients appear restenosis. 16 patients, did not appear restenosis ; 4 patients appear restenosis. Restenosis interphase time or Clinical stationary time was increased from （ 10. 95± 5.49 ） days before the therapy to （ 98.75 ± 55.58 ） days after therapy of local injection of TA（P 〈 0. 01 ）. The long-term outcome, the control group 20 eases restenosis in a 6 months follow-up time. After 6 months the the airway diameter of treatment group is （ 8. 70± 2. 52 ） mm compared with control group（4. 50 ± 1.64）mm, （P 〈0. 01 ） ; the airway narrow rate of treatment group is （29. 17 ± 14. 55）%, compared with control group （64. 80± 13.35 ）%, （P 〈 0. 01 ） ; breathlessness score of treatment group is （0. 55 ＋ 0. 76）, compared with control group （ 2. 70 ±0. 92, P 〈 0. 01 ）, with statistically

关 键 词：曲安奈德 局部注射 良性气道狭窄 难治性 

分 类 号：R562[医药卫生—呼吸系统]