Servicio de Neumología, Hospital Universitario La Paz, Madrid, España; Unidad de broncoscopias, Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
Servicio de Neumología Intervencionista, Clínica Alemana-Universidad del Desarrollo de Chile, Santiago de Chile, Chile.
Arch Bronconeumol. 2014 Aug;50(8):345-54. doi: 10.1016/j.arbres.2013.12.012. Epub 2014 Apr 3.
The most common causes of non-malignant central airway obstruction are post-intubation and post-tracheostomytracheal stenosis, followed by the presence of foreign bodies, benign endobronchial tumours and tracheobronchomalacia. Other causes, such as infectious processes or systemic diseases, are less frequent. Despite the existence of numerous classification systems, a consensus has not been reached on the use of any one of them in particular. A better understanding of the pathophysiology of this entity has allowed us to improve diagnosis and treatment. For the correct diagnosis of nonspecific clinical symptoms, pulmonary function tests, radiological studies and, more importantly, bronchoscopy must be performed. Treatment must be multidisciplinary and tailored to each patient, and will require surgery or endoscopic intervention using thermoablative and mechanical techniques.
非恶性中央气道阻塞最常见的原因是插管后和气管切开后气管狭窄,其次是异物、良性支气管内肿瘤和气管支气管软化。其他原因,如感染过程或全身性疾病,较为少见。尽管存在许多分类系统,但尚未就使用其中任何一个系统达成共识。对该实体病理生理学的更好理解使我们能够改善诊断和治疗。为了正确诊断非特异性临床症状,必须进行肺功能测试、影像学研究,更重要的是,进行支气管镜检查。治疗必须是多学科的,并针对每个患者进行定制,并且需要使用热消融和机械技术进行手术或内镜介入。