体外高频超声在良性颈段气管狭窄治疗随访分析  

Follow-up analysis of benign cervical tracheal stenosis therapy through extracorporeal high-frequency ultrasound

作　　者：何玮华[1] 汤佳馨 周大治[1] 何珂 杜继业[1] 汤庆[1] He Weihua;Tang Jiaxing;Zhou Dazhi;He Ke;Du Jiye;Tang Qin(Department ofUltrasound;Institute of Respiratory Diseases,The First Affiliated hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院超声科,广州510120 [2]广州医科大学附属第一医院呼吸病研究所,广州510120

出　　处：《中华肺部疾病杂志（电子版）》2018年第3期309-313,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：广东省省级科技计划项目(2017A020215062)

摘　　要：目的探讨体外高频超声在良性颈段气管狭窄治疗随访观察中的临床价值。方法应用体外高频超声随访观察65例良性颈段气管狭窄患者,其中复发性多软骨炎呼吸道受累者6例(9.2%)及颈段气管增生性或瘢痕性狭窄者59例(90.8%),后者包括经口气管插管者30例(46.2%)、颈段气管切开者28例(43.1%)、颈段气管支架嵌顿变形者1例(1.5%)。治疗后及1、3、6个月进行体外高频超声复查,观察气管狭窄处气管内横径、气管软骨厚度、气管壁软组织厚度及再狭窄等情况并测量,以治疗前与治疗后6个月超声测值统计学配对t检验比较判断其疗效。结果复发性多软骨炎呼吸道受累者超声表现为软骨环增厚最具特征性,经药物联合治疗后超声随诊,气管软骨厚度由治疗前(4.8±2.73)mm减低至治疗后(2.5±1.71)mm;气管内横径由治疗前(8.96±0.95)mm增加至治疗后(15.10±0.94)mm;患者半年随访过程中病情稳定无复发。颈段气管增生性或瘢痕性狭窄者经介入治疗后,狭窄段气管内横径由治疗前(6.52±2.36)mm增加至治疗后(10.30±2.76)mm;气管壁软组织厚度由治疗前(3.40±2.78)mm减少至治疗后(2.12±1.40)mm。治疗后1、3、6个月气管狭窄复发率为33.9%、1.7%、1.7%,复发者超声表现为狭窄段气管软组织不均匀增厚向腔内突出,致管腔狭窄。结论体外高频超声检查可以在良性气管狭窄治疗后为疗效评估提供参考价值。Objective To investigate the value of extracorporeal high-frequency ultrasound（ EHFUS）in fellow-up of benign cervical tracheal stenosis therapy. Methods Sixty-five patients after treatment identified diagnosis by pathology,bronchoscopy and computerized tomography,including 6 relapsing polychondritis（ RP）patients and 59 post intubation or tracheotomy patients. EHFUS was used to observing imaging features,measuring their intra-diameter transverse of cervical trachea and thickness-diameter of the tracheal cartilage and thickness of the tracheal wall parenchyma of benign cervical tracheal stenosis. Fellow-up evaluation was performed in 65 patients by EHFUS after therapy and at 1,3,6 months. The measures before the therapy with the measures of the 6 month after therapy were compared. Results Six RP patients did not appear restenosis.Their intra-diameter transversa of cervical trachea was increased from 8. 96 ± 0. 95 mm before the therapy to15.10±0.94 mm after therapy. The thickness-diameter of the cervical tracheal cartilage was reduced from 4.8±2.73 mm before the therapy to 2.5±1.71 mm after therapy. To 59 postintubation or tracheomoty patients,their intra-diameter transversa of cervical trachea was increased from 6.52±2.36 mm before the therapy to 10.30±2.76 mm after therapy. The thickness-diameter of the tracheal wall parenchyma was reduced from 3. 40 ± 2. 78 mm before the therapy to 2.12±1.40 mm after therapy. The recurrence rate in 1,3 and 6 month after interventional treatment were 33.9%,1.7% and1.7% respectively. Conclusion EHFUS may be a valuable assistant method to assess in fellow-up of benign cervical tracheal stenosis therapy.

关 键 词：气管狭窄 良性病变 高频超声 

分 类 号：R563[医药卫生—呼吸系统]