插管后气管狭窄介入治疗的疗效及其影响因素分析

发布时间：2018-04-22 11:50

  本文选题：气管狭窄 + 气管插管　； 参考：《中国呼吸与危重监护杂志》2017年04期

【摘要】：目的探讨插管后气管狭窄呼吸介入治疗的疗效并分析其相关影响因素。方法回顾性分析2010年2月至2015年3月广州医科大学附属第一医院诊治的69例插管后气管狭窄患者的临床资料,通过查阅病历和电话随访1年以上,分析呼吸介入治疗插管后气管狭窄的疗效,应用多元Logistic回归模型分析其疗效的影响因素。结果 69例气管插管后气管狭窄病例中,男36例,女33例;中位年龄44岁;共接受呼吸介入治疗275次,平均3.98次/例。患者经呼吸介入治疗后气促症状缓解,ATS气促评分由(2.41±0.76)分降至(0.65±0.62)分(P0.01),气管内径由(4.24±2.05)mm增加至(10.57±3.14)mm(P0.01)。呼吸介入治疗的近期有效率为92.8%(64/69),治疗后1个月、3个月、1年内再狭窄的比例分别为56.5%、26.1%和36.2%。多元Logistic回归分析显示合并糖尿病(OR=2.819,95%CI 1.973~4.062)、气促评分3分(OR=13.816,95%CI 5.848~32.641);气管狭窄段直径4.5 mm(OR=7.482,95%CI 4.015~13.943)、狭窄分级≥4级(OR=3.815,95%CI 2.258~6.447)、气管上段狭窄(OR=5.173,95%CI 3.218~8.316)与呼吸介入治疗后再狭窄的发生率呈正相关。结论气管插管后气管狭窄介入治疗的总体疗效欠佳,复发率仍较高。气管狭窄程度高、合并糖尿病及气管上段狭窄是影响呼吸介入治疗疗效的重要因素。
[Abstract]:Objective to investigate the effect of interventional therapy for tracheal stenosis after intubation and analyze its related factors. Methods the clinical data of 69 patients with tracheal stenosis after intubation in the first affiliated Hospital of Guangzhou Medical University from February 2010 to March 2015 were analyzed retrospectively. Objective: to analyze the effect of respiratory interventional therapy on tracheal stenosis after intubation, and to analyze the influencing factors by multiple Logistic regression model. Results among 69 cases of tracheal stenosis after tracheal intubation, 36 cases were males and 33 cases were females, the median age was 44 years old, 275 times of respiratory interventional therapy (mean 3.98 times / case). After respiratory interventional therapy, the score of ATS for relief of dyspnea symptoms decreased from 2.41 卤0.76 to 0.65 卤0.62min (P 0.01), and the trachea diameter increased from 4.24 卤2.05)mm to 10.57 卤3.14mm / L P0.01a. The short term effective rate of respiratory interventional therapy was 92.8% and the proportion of restenosis within 1 month, 3 months and 1 year after treatment was 56. 5% and 36. 2%, respectively. Multiple Logistic regression analysis showed that there was a positive correlation between the incidence of restenosis in the trachea stenosis segment (4.01595 CI 4.01543), the stenosis grade 鈮，

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