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摘要: 目的 探讨特发性声门下狭窄(ISS)的诊治方法和预后。方法 回顾性分析特发性声门下狭窄15例患者的临床资料。采用Myer-Cotton气道分级系统对狭窄程度进行分级：Ⅰ度0例，Ⅱ度8例，Ⅲ度4例，Ⅳ度3例。结果 随访0.5~10年，所有患者全部成功拔管，无窒息、脱管及伤口不愈合等严重并发症发生，无再次狭窄。结论 对于处在无进展期的特发性声门下狭窄患者，应当采取积极的手术治疗策略，并进行个体化治疗，预后满意。Abstract: Objective The aim of this study is to o explore the diagnosis, treatment and prognosis of idiopathic subglottic stenosis (ISS)Method The clinical data of 15 patients with idiopathic subglottic stenosis treated in our department were analyzed retrospectively. The degree of stenosis was classified by the Cotton Airway grading system of Myer, with 8 cases of gradeⅡ, 4 cases of grade Ⅲ and 3 cases of grade Ⅳ.Result The time of follow-up of HTSS was 0.5-10 years. All 15 patients were successfully extubated without asphyxia, decannulation and wound nonunion.Conclusion For patients with idiopathic subglottic stenosis in the non-progressive stage, active surgical treatment strategy should be adopted and treated individually. The prognosis is satisfactory.
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表 1 15例患者的临床资料
例序 性别 年龄/岁 Myer-Cotton分级 狭窄长度/cm 既往外院手术史 手术方式 1 女 29 Ⅱ 2.0 无 喉气管裂开成形术 2 女 31 Ⅱ 3.0 无 2次喉气管裂开成形术 3 男 54 Ⅲ 2.5 无 环气管切除端端吻合术 4 女 22 Ⅱ 0.5 无 支撑喉镜下球囊扩张 5 女 48 Ⅱ 2.5 首次手术部分喉切除+气管新生物切除+肋软骨及邻近皮瓣转移喉气管成形术，2次手术支撑喉镜下喉瘢痕切除术 喉气管裂开成形术 6 男 16 Ⅱ 1.0 环气管瘢痕切除端端吻合术 2次喉气管裂开成形术 7 男 18 Ⅱ 1.0 无 6次支撑喉镜下球囊扩张 8 女 40 Ⅳ 4.0 首次手术喉裂开成形术及T型管置入，2次手术同前 喉气管裂开成形术 9 女 23 Ⅲ 1.5 无 喉气管裂开成形术 10 男 64 Ⅱ 2.0 无 喉气管裂开成形术 11 女 44 Ⅳ 2.5 无 喉气管裂开成形术 12 女 36 Ⅱ 3.0 支撑喉镜下激光瘢痕切除 喉气管裂开成形术 13 女 41 Ⅲ 2.0 支撑喉镜下球囊扩张 2次喉气管裂开成形术 14 女 65 Ⅲ 3.0 喉裂开成形术 2次喉气管裂开成形术 15 女 29 Ⅳ 2.0 无 环气管切除端端吻合术 
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