Zhang Jie, Wang Juan, Wang Ting, Xu Min, Dang Bin-wen, Pei Ying-hua, Zhang Chen-yang
Department of Pulmonary Medicine, Capital Medical University, Beijing 100, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2011 May;34(5):334-8.
To evaluate the efficacy of different interventional bronchoscopic techniques for the management of benign cicatricial hyperplasia airway stenosis, and to study the factors associated with the treatment effects.
From December 2004 to December 2009, 36 patients with cicatricial airway stenosis were admitted to our department. An investigation was made to analyze the effects by different interventional bronchoscopic treatments. The most suitable treatment modality for cicatricial airway stenosis was explored and described.
For the 36 patients, the disease was cured in 9, improved in 10, not improved in 12, and failure in 5. The cure rate, effective rate and ineffective rate were 25%, 53% and 47%, respectively. Further analysis showed that the effective rate was 8% and 82% respectively for the electrical coagulation therapy and the balloon dilation combined with needle electrical knife and/or cryotherapy. Restenosis extension after operation occurred in 67% of the cases by electrical coagulation therapy, but only 12% of cases by the balloon dilation combined with needle electrical knife and/or cryotherapy.
Our experience demonstrated that for the treatment of airway cicatricial stenosis, electrical coagulation might induce and worsen serious airway restenosis resulting in failure of treatment. On the other hand, balloon dilation combined with needle electrical knife and/or cryotherapy might be a relative safe and effective therapy for airway cicatricial stenosis.
评估不同介入性支气管镜技术治疗良性瘢痕性增生性气道狭窄的疗效，并研究与治疗效果相关的因素。
2004年12月至2009年12月，36例瘢痕性气道狭窄患者入住我科。进行调查以分析不同介入性支气管镜治疗的效果。探索并描述了治疗瘢痕性气道狭窄最合适的治疗方式。
36例患者中，治愈9例，好转10例，未好转12例，失败5例。治愈率、有效率和无效率分别为25%、53%和47%。进一步分析显示，电凝治疗和球囊扩张联合针状电刀及/或冷冻治疗的有效率分别为8%和82%。电凝治疗术后再狭窄扩展发生率为67%，而球囊扩张联合针状电刀及/或冷冻治疗仅为12%。
我们的经验表明，对于气道瘢痕性狭窄的治疗，电凝可能会诱发并加重严重的气道再狭窄，导致治疗失败。另一方面，球囊扩张联合针状电刀及/或冷冻治疗可能是治疗气道瘢痕性狭窄相对安全有效的方法。
