喉罩通气下冷冻联合球囊扩张治疗严重良性中央气道狭窄的临床研究

发布时间：2018-04-29 12:27

本文选题：喉罩 + 冷冻治疗　；参考：《山东大学学报(医学版)》2014年11期

【摘要】：目的观察喉罩通气下经电子支气管镜冷冻联合球囊扩张治疗严重良性气道狭窄的近、远期疗效和安全性。方法选取2011年1月至2013年12月严重良性中央气道狭窄的患者45例,在喉罩通气下给予冷冻联合球囊扩张治疗,比较治疗前后气道直径、一秒用力呼气容积(FEV1)、Hugh-Jones分级、血氧分压(Pa O2)和生活质量评分等指标的变化,并随访治疗的近、远期疗效和并发症。结果经过3~8个疗程治疗后,气道直径、FEV1、Hugh-Jones分级、Pa O2和生活质量评分等指标有明显改善(P0.05)。45例患者中38例(84.4%)缓解良好,狭窄部位气管内径达到原气管内径50%以上,肺叶完全复张;7例(15.6%)缓解良好,肺叶部分复张。近期不良反应:咽痛、咳嗽11例(22.4%),出血17例(37.8%),气胸2例(4.4%);随访18个月远期效果:5例(11.1%)患者出现再狭窄(平均2.5个月),给予冷冻及球囊扩张治疗后缓解。结论喉罩通气下冷冻联合球囊扩张治疗严重良性气道狭窄效果显著、安全性高、疗效确切,值得推广。
[Abstract]:Objective to observe the short- and long-term efficacy and safety of laryngeal mask ventilation combined with balloon dilation in the treatment of severe benign airway stenosis. Methods from January 2011 to December 2013, 45 patients with severe benign central airway stenosis were treated with cryopreservation combined with balloon dilatation under laryngeal mask ventilation. The airway diameter and forced expiratory volume of one second were compared with FEV1 Hugh Hugh Jones grade before and after treatment. The changes of blood partial pressure of oxygen (Pao _ 2) and quality of life score (QOL) were followed up. Results after 3 ~ 8 courses of treatment, the airway diameter, FEV1 / Hugh -Jones grading, Pao 2 and quality of life score were significantly improved in 38 out of 45 patients (P 0.05, n = 45). The trachea diameter in the narrow area was more than 50% of the original trachea diameter. There was good remission in 7 cases with complete reopening of the lobes and partial reexpansion of the lobes. The short-term adverse reactions were: pharynx pain, cough in 11 cases with 22. 4%, hemorrhage in 17 cases (37. 8%), pneumothorax in 2 cases (4. 4%), follow up for 18 months in 5 cases (n = 5) with restenosis (mean 2. 5 months) and remission after cryotherapy and balloon dilatation. Conclusion cryopreservation combined with balloon dilatation under laryngeal mask ventilation is effective, safe and effective in the treatment of severe benign airway stenosis.
【作者单位】：武汉市中心医院呼吸内科;
【分类号】：R563

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