使用 Montgomery T 硅酮支架治疗声门下良性气道狭窄的 32 例临床分析。

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM Canadian respiratory journal Pub Date : 2024-10-16 eCollection Date: 2024-01-01 DOI:10.1155/2024/2145560
Zhenyu Yang, Xiaoli Zhou, Wenying Pan, Daxiong Zeng, Junhong Jiang
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引用次数: 0

摘要

目的探讨长期放置蒙哥马利 T 型硅胶支架(T 型管)治疗声门下良性气道狭窄(SBAS)的并发症以及成功拔除 T 型管的时机。方法我们回顾性地收集了 32 例接受 T 型管治疗的 SBAS 患者的临床资料,并分析了他们放置和成功拔除 T 型管的情况。结果:男 22 例,女 10 例:其中男性 22 例,女性 10 例,年龄从 21 岁到 79 岁(60.9±13.7)岁。所有 32 名患者都成功置入了 T 型管,其中 6 名轻度狭窄患者(18.8%)在静脉清醒镇静的情况下置入了 T 型管。最长随访时间为 60.4 个月,17 名患者(53.1%)留置 T 型管超过 12 个月;5 名患者(15.6%)因各种原因意外拔除 T 型管后改用气管造口插管;9 名患者(28.1%)成功拔除 T 型管,留置 T 型管时间为 5.2-22.7 个月(12.1±6.3 个月),其中 9 名患者(100%)为解剖性狭窄。32 例患者(100%)出现分泌物潴留,9 例患者(28.1%)出现肉芽组织增生,通过支气管镜治疗和随访,大多数患者的正常通气未受影响;3 例患者因严重并发症而拔除 T 型管。1周、1个月、3个月和12个月时点的分泌物潴留和肉芽组织增生发生率无明显差异,P>0.05。在插管超过 12 个月的患者中,1 周、1 个月、3 个月和 12 个月时分泌物潴留的严重程度有显著差异(P < 0.05),但肉芽组织增生的严重程度无显著差异(P > 0.05)。结论T管治疗SBAS安全有效。长期放置 T 型管的患者分泌物潴留的严重程度增加。对于轻度狭窄和解剖性狭窄的患者,可在随访 1 年左右时尝试拔除 T 型管。
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Clinical Analysis of 32 Cases of Subglottic Benign Airway Stenosis Treated With Montgomery T Silicone Stent.

Objective: To explore the complications of long-term placement of Montgomery T silicone stent (T-tube) in the treatment of subglottic benign airway stenosis (SBAS) and the timing of successful T-tube removal. Methods: We retrospectively collected the clinical data of 32 patients with SBAS who underwent the treatment of T-tube and analyzed their placement and successful removal of the T-tube. Results: There were 22 males and 10 females, aged from 21 to 79 years (60.9 ± 13.7 years). The T-tubes were successfully placed in all 32 patients, and 6 patients (18.8%) with mild stenosis were placed by the intravenous conscious sedation. The longest follow-up period was 60.4 months, and 17 patients (53.1%) had the T-tubes for more than 12 months; 5 patients (15.6%) were changed to the tracheostomy cannula after unplanned removal of the T-tubes for various reasons; the T-tubes were successfully removed in 9 patients (28.1%), and the duration of T-tubes placement was 5.2-22.7 months (12.1 ± 6.3 months), among them anatomical stenosis in 9 patients (100%). Secretion retention was observed in 32 patients (100%), granulation tissue hyperplasia was observed in 9 patients (28.1%), and the normal ventilation was not affected in most patients by bronchoscopic treatment and follow-up; the T-tubes were removed in 3 patients due to severe complications. There was no significant difference in the incidences of secretion retention and granulation tissue hyperplasia between the time point at 1 week, 1 month, 3 months, and 12 months, p > 0.05. In patients with T-tube more than 12 months, the severity of secretion retention at 1 week, 1 month, 3 months, and 12 months was significantly different, p < 0.05, however, there was no significant difference in the severity of granulation tissue hyperplasia, p > 0.05. Conclusions: T-tube is safe and effective in the treatment of SBAS. The severity of secretion retention increased in patients with long-term placement of the T-tube. For patients with mild stenosis and anatomical stenosis, the T-tube removal can be attempted at about 1 year of follow-up.

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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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