外科气道成形术治疗良性气道狭窄的疗效。

Takuma Tsukioka, M. Takahama, R. Nakajima, M. Kimura, Hidetoshi Inoue, Ryoji Yamamoto
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引用次数: 3

摘要

背景:良性气道狭窄的治疗需要长期通畅。本研究探讨了外科气道成形术治疗良性气道狭窄的有效性。方法回顾性分析20例良性气道狭窄手术治疗的临床过程。结果气管狭窄原因为气管支气管结核12例,气管插管后狭窄5例,软化2例,其他1例。进行了28例介入肺部手术和20例外科成形术。5例气管插管后狭窄患者和4例结核性狭窄患者行气管成形术。8例结核性狭窄患者接受支气管成形术治疗,2例软化患者接受膜部稳定治疗。吻合口狭窄4例,需要1 ~ 4次额外治疗。手术成形术后患者的功能状态、Hugh-Jones分类和通气功能均有改善。结核性狭窄和马拉西亚患者的结果尚可。然而,没有观察到手术成形术治疗插管后狭窄的疗效。结论手术气道成形术是治疗结核性狭窄的有效方法。患者在手术成形术后恢复良好。可能有未经治疗的马拉西亚患者有可能从手术成形术中获益。
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Efficacy of Surgical Airway Plasty for Benign Airway Stenosis.
BACKGROUND Long-term patency is required during treatment for benign airway stenosis. This study investigated the effectiveness of surgical airway plasty for benign airway stenosis. METHODS Clinical courses of 20 patients, who were treated with surgical plasty for their benign airway stenosis, were retrospectively investigated. RESULTS Causes of stenosis were tracheobronchial tuberculosis in 12 patients, post-intubation stenosis in five patients, malacia in two patients, and others in one patient. 28 interventional pulmonology procedures and 20 surgical plasty were performed. Five patients with post-intubation stenosis and four patients with tuberculous stenosis were treated with tracheoplasty. Eight patients with tuberculous stenosis were treated with bronchoplasty, and two patients with malacia were treated with stabilization of the membranous portion. Anastomotic stenosis was observed in four patients, and one to four additional treatments were required. Performance status, Hugh-Jones classification, and ventilatory functions were improved after surgical plasty. Outcomes were fair in patients with tuberculous stenosis and malacia. However, efficacy of surgical plasty for post-intubation stenosis was not observed. CONCLUSION Surgical airway plasty may be an acceptable treatment for tuberculous stenosis. Patients with malacia recover well after surgical plasty. There may be untreated patients with malacia who have the potential to benefit from surgical plasty.
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