腔镜下球囊扩张气管成形术治疗儿童获得性声门下狭窄的疗效分析

焦宇; 黄琦; 张治华; 吕静荣; 杨军; 吴皓

doi:10.13201/j.issn.1001-1781.2016.24.006

腔镜下球囊扩张气管成形术治疗儿童获得性声门下狭窄的疗效分析

- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科上海交通大学医学院耳科学研究所上海市耳鼻疾病转化医学重点实验室(上海, 200092)
基金项目:
上海市卫生和计划生育委员会科研项目资助(No:201540196)

详细信息

通讯作者: 焦宇,E-mail:entjiaoyu@163.com

中图分类号: R767.4

收稿日期: 2016-09-19

Effect of balloon dilation tracheoplasty in the management of acquired subglottic stenosis in children

- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China

More Information

Corresponding author: JIAO Yu, E-mail: entjiaoyu@163.com

Received Date: 19 September 2016

摘要

摘要: 目的:评价腔镜下球囊扩张气管成形术治疗儿童获得性声门下狭窄的效果及安全性。方法:应用腔镜下球囊扩张气管成形术治疗23例获得性声门下狭窄患儿,探讨腔镜下球囊扩张气管成形术对儿童获得性声门下狭窄的疗效、适应证及安全性。结果:23例患儿中,11例术前气管切开患儿中6例成功拔管,11例痊愈且避免气管切开,1例接受开放式喉气管成形术,5例仍在随访中,总有效率为73.91%。全部患儿中Cotton Ⅰ级狭窄1例,治愈1例,有效率100.00%;Ⅱ级狭窄6例,治愈5例,有效率83.33%;Ⅲ级狭窄16例,治愈11例,有效率68.75%。12例患儿发生术后再狭窄,发生率为52.17%,均接受多次扩张治疗,平均扩张次数为1.87次。新鲜瘢痕组9例,治愈8例(88.9%),平均手术扩张次数1.22次;陈旧瘢痕组14例,治愈8例(57.14%),平均手术扩张次数2.23次,两组平均手术次数比较差异有统计学意义(P<0.05)。结论:腔镜下球囊扩张气管成形术是治疗儿童获得性声门下狭窄的安全、有效方法,手术对不同病变类型病例均有良好的治疗效果,但瘢痕早期接受手术的患儿平均手术次数更少,疗程更短。
- 球囊扩张 /
- 气管成形术 /
- 声门下狭窄 /
- 儿童
Abstract: Objective: To assess the efficiency and safety of balloon dilation tracheoplasty technique in the management of acquired subglottic stenosis in children.Method: Twenty-three cases were diagnosed as acquired subglottic stenosis by chest CT scan and bronchoscpy,and received the treatment of the balloon dilatation tracheoplasty.The data about the efficiency,complication and prognosis of the treatment were collected.Result: In the 23 cases,6 of All 11 patients with tracheotomy were decannulated,11 patients were successfully managed without tracheotomy,1 patients received laryngotracheal reconstruction(LTR) surgery, 5 cases were still under observation. The overall response rate was 73.91%.All cases were divided into three stages according to Cotton stage system:1 cases were stage Ⅰ stenosis,6 cases were stage Ⅱ and 16 cases were stage Ⅲ. The response rate was 100.00%,83.33%,and 68.75% respectively. The most common complication in the balloon dilatation tracheoplasty was restenosis. Restenosis occurs in 12(52.17%) cases who received more than 1 dilation procedures in this study. Over all average dilation times is 1.87. Eight cases(88.9%) of 9 in fresh leision group were recoverd, the average dilation time is 1.22; 8 cases (57.14%) of 14 in old leision group were recoverd, the average dilation time is 2.23. The average dilation time between two group is significant(P<0.05).Conclusion: Subglottic stenosis in pediatric patients can be successfully managed with balloon dilation tracheoplasty. In patients without prior tracheotomy, tracheotomy can often be safely avoided with appropriate postoperative management.
- balloon dilation /
- tracheoplasty /
- subglottic stenosis /
- child

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