气道内支架在Slide气管成形术后并发症的应用  

Efficacy of airway stenting for postoperative complications of slide tracheoplasty

作　　者：吕效政 王超[2] 杨彦亮 徐惠惠[1] 毕思明[1] 王广震[1] 王卫敏 庞亚昌 冯致余[1] Lyu Xiaozheng;Wang Chao;Yang Yanliang;Xu Huihui;Bi Siming;Wang Guangzhen;Wang Weimin;Pang Yachang;Feng Zhiyu(Department of Cardiac Surgery,Afiliated Children's Hospital,Shandong University,Jinan Children's Hospital,Jinan 250022,China;Department of Respiratory Intervention,Affiliated Children's Hospital,Shandong University,Jinan Children's Hospital,Jinan 250022,China)

机构地区：[1]山东大学附属儿童医院(济南市儿童医院)心脏外科,济南250022 [2]山东大学附属儿童医院(济南市儿童医院)呼吸介入科,济南250022

出　　处：《中华小儿外科杂志》2024年第10期903-906,共4页Chinese Journal of Pediatric Surgery

基　　金：山东省科技示范工程(2021SFGC0503)。

摘　　要：目的探讨气道内支架治疗Slide气管成形术后并发症的疗效。方法回顾性分析2017年2月至2022年6月在山东大学附属儿童医院接受Slide气管成形术且术后于吻合段置入气道内支架的6例患儿临床资料,其中男5例,女1例;患儿接受气管成形术的平均年龄为3岁,范围在3个月至8岁;患儿接受气管成形术的平均体重为16.9 kg,范围在4.6~39.0 kg。2例患儿因吻合口内凸严重分别于术后48 d、55 d置入硅酮支架;3例患儿因术后吻合段气管重度软化,出现反复喘憋、撤机困难分别于术后10 d、21 d、49 d置入硅酮支架;1例患儿因术后吻合段瘢痕增生、气管再狭窄,保守治疗效果不佳,于术后416 d置入硅酮支架。结果6例患儿置入气道内支架后临床症状明显改善,取出内支架后复查气管镜均提示吻合段气管内凸、软化、再狭窄等情况较前明显好转。6例患儿气道内支架置入至取出的平均时间为104.3 d,范围在27~167 d。所有患儿支架取出后平均随访19.3个月,患儿均无明显呼吸道症状,活动耐力基本正常。结论气道内支架置入能够有效治疗Slide气管成形术后吻合段内凸、软化、狭窄等情况。Objective To explore the efficacy of airway stenting for complications after slide tracheoplasty in children.Methods From February 2017 to June 2022,the relevant clinical data were retrospectively reviewed for 6 children undergoing slide tracheoplasty and airway stenting.There were 5 boys and 1 girl with an average operative age of 36(3-108)year and an average weight of 16.9(4.6-39.0)kg.Two children of severe anastomotic bulging underwent airway stenting at Day 48/55 postoperatively.Three cases of severe softening of anastomotic segment developed dyspnea and ventilator weaning was difficult.Airway stenting was performed at Day 10/21/49 postoperatively.One child of narrow anastomotic segment responded poorly to repeated balloon dilatation.Airway stenting was performed at Day 416 postoperatively.Results Clinical symptoms of 6 children significantly improved after airway stenting.After extracting stent,bronchoscopy indicated that bulging,softening and restenosis improved markedly in anastomotic segment.The average stenting time was 104.3(27-167)days.Conclusions Airway stent may effectively treat bulging,softening and stenosis of anastomotic segment after slide tracheoplasty.

关 键 词：气管狭窄 气管成形术 手术并发症 

分 类 号：R726.5[医药卫生—儿科]