支气管镜下钬激光消融术治疗婴幼儿声门下狭窄的临床研究  

Clinical study of holmium laser ablation in treatment of infants and young children with windpipe stenosis under bronchoscope

作　　者：黄冬平[1] 黄苑铭[1] 黎静[1] 鲁灵龙[1] 李敏敏[1] 唐远平[1] 彭淑梅[1] 陈运彬[1] 

机构地区：[1]广东省妇幼保健院儿科,广东广州510010

出　　处：《临床肺科杂志》2017年第8期1400-1403,共4页Journal of Clinical Pulmonary Medicine

基　　金：广东省科技厅科技计划项目(No 2016ZC0187)

摘　　要：目的探讨支气管镜下钬激光消融术治疗婴幼儿气道狭窄的临床疗效及安全性。方法选取气道狭窄的患儿10例,其中气管插管后气管瘢痕引起气管重度狭窄6例;先天性气管蹼4例。分别于术前和术后评估临床症状、支气管镜下病变部位情况、血气分析以及胸部CT的改变。结果 10例患儿接受激光治疗手术后,效果显著8例:气道内狭窄完全解除,腔内的病灶完全清除,临床症状完全改善。有效2例:超过或等于50%的狭窄管腔解除,腔内的病灶部分清除,通气功能部分恢复功能,临床症状安静时基本改善,胸部CT的气道狭窄处和肺不张范围较前缩小2/3-1/2。总体有效率达100%。治疗术中和术后无出现严重并发症,经随访1年均未见复发。结论支气管镜下钬激光消融术治疗婴幼儿声门下狭窄安全、有效,在临床上值得进一步观察研究。Objective To investigate the curative effect and safety of of holmium laser ablation in treatment of infants and young children with windpipe stenosis under bronchoscope.Methods 10 children with windpipe stenosis admitted in pediatric department of Guangdong Maternal and Child Health Hospital from January 2013 to January 2015 were enrolled in this study,including 6 cases of endotracheal intubation after scar caused severe tracheal stenosis and 4 cases of congenital tracheal web.Preoperative and postoperative assessment of clinical symptoms,bronchoscopic lesion site,blood gas analysis and chest CT changes were conducted.Results 10 cases were given laser treatment,and the results were significant in 8 cases,including complete removal of the windpipe stenosis,complete removal of the lesions within the cavity,and completely improved clinical symptoms.2 cases were effective,including more than or equal to 50% of the stenosis lumen dissolution of the cavity,part of the removal of the lesion,ventilatory function part of the recovery,clinical symptoms of silence basically improved,and chest CT narrowing of the airway atelectasis and narrow range 2/3 to 1/2.The overall effective rate was 100%.There was no serious complication during and after operation.Conclusion Holmium laser ablation under bronchoscopy is safe and effective in treatment of infrarenal subglottic stenosis.It is worthy of promotion in clinical practice.[Key words]windpipe stenosis;laser ablation;bronchoscopy

关 键 词：气道狭窄 激光消融 支气管镜 

分 类 号：R726.5[医药卫生—儿科]