支气管镜介入联合雾化吸入综合治疗损伤性气管狭窄的疗效及影响因素分析  

The efficacy of comprehensive treatment to traumatic tracheal stenosis

作　　者：冯洁美[1] 谭泰英[1] 蒙锦祥 覃淑娟[1] 黄进代[1] FENG Jie-mei;TAN Tai-ying;MENG Jin-xiang(Department of pulmonary and critical care medicine,Guigang people's hospital,Guigang 537100,China)

机构地区：[1]贵港市人民医院呼吸与危重症医学科,广西贵港537100

出　　处：《吉林医学》2020年第6期1307-1309,共3页Jilin Medical Journal

摘　　要：目的:探讨综合治疗损伤性气管狭窄的疗效和影响疗效的因素。方法:回顾分析损伤性气管狭窄22例患者的综合治疗过程,包括支气管镜下热消融、活检钳机械清除增生组织、球囊扩张、冷冻治疗联合雾化吸入药物(布地奈德和阿米卡星)。分析治疗效果及影响因素。结果:22例患者气管内径由治疗前的(3.95±2.09)mm增加至最后一次治疗结束时的(10.01±2.56)mm,差异有统计学意义(t=8.602,P<0.01),气促指数由治疗前的3.46±0.75下降至0.64±0.47,差异有统计学意义(t=14.944,P<0.01),FEV 1由治疗前的(1.83±0.75)L增加至(3.25±0.68)L,差异有统计学意义(t=6.345,P<0.01)。停止治疗随访6个月,22例患者气管内径、气促指数和FEV 1与最后一次治疗结束时对比,气管内径(9.78±1.86)mm(t=0.341,P>0.05),气促指数0.45±0.43(t=1.399,P>0.05),FEV 1(3.10±0.74)L(t=1.253,P>0.05),以上差异均无统计学意义(P>0.05),以上差异均无统计学意义(P>0.05)。总疗程为3~12个月,疗程>6个月的患者有12例,均为曾采用氩气刀热消融的患者。结论:支气管镜介入联合雾化吸入药物的综合治疗气管狭窄有效,影响疗效的因素可能与氩气刀热消融造成的气管黏膜损伤扩大有关。Objective To investigate the efficacy and influencing factors of comprehensive treatment in traumatic tracheal stenosis.Method 22 patients with tracheal stenosis in our hospital were collected to be retrospectively analysed.They were treated with the comprehensive bronchoscope treatment including thermal ablation,mechanical remove of hyperplastic tissue by biopsy forceps,balloon expansion,freezing treatment and inhalation of drug(budesonide and amikacin).Results The endotracheal diameter of the 22 patients was increased from(3.95±2.09)mm before treatment to(10.01±2.56)mm(t=8.602,P<0.01)after the last treatment,dyspnea index was decresed from 3.46±0.75 to 0.64±0.47(t=14.944,P<0.01),FEV1 was increased from(1.83±0.75)L to(3.25±0.68)L(t=6.345,P<0.01).After 6 months of follow-up,comparing with the last treatment,The endotracheal diameter of the patients was(9.78±1.86)mm(t=0.341,P>0.05),dyspnea index was 0.45±0.43,the difference was not statistically significant(t=1.399,P>0.05),FEV1 was(3.10±0.74)L(t=1.253,P>0.05).The total course of treatment was 3 to 12 months.12 patients who were treated with APC need a course of treatment more than 6 months.Conclusion The efficacy of comprehensive treatment to traumatic tracheal stenosis through bronchoscopic intervention combined with inhalation of drug is for sure.The influencing factors of the efficacy may be related to the enlargement of tracheal mucosal injury caused by APC.

关 键 词：气管狭窄 热消融 冷冻疗法 疗效 

分 类 号：R653[医药卫生—外科学]