Cheng Y, Zhang W, Zhang H, Liu Y, Li N, Cao J, Wang G F
Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2017 Jan 12;40(1):29-33. doi: 10.3760/cma.j.issn.1001-0939.2017.01.007.
To assess the effectiveness of Ho: YAG Laser in the treatment of broncholithiasis. We retrospectively reviewed the clinical data of 6 patients who underwent Ho: YAG Laser lithotripsy in Peking University First Hospital during May 2012 to October 2015. 4 females and 2 males, with a median age of 60 years, were enrolled. Among 6 patients, persistent cough(=2), hemoptysis(=2), recurrent pneumonia(=2) were the main clinical symptoms. Broncholiths were found in the left side in 1 patient and right side in 5 patients. 2 broncholiths were located in main bronchus and 4 in segmental bronchus. There were 2 patients with intraluminal broncholiths and 4 with transbranchial broncholiths. All 6 patients received Ho: YAG Laser(0.8-1.2 J pulse energies, 5-10 Hz frequencies, 365 μm laser fibers) under rigid bronchoscopy in general anesthesia and experienced relief of symptoms. Complete removal of broncholith was accomplished in intraluminal broncholith group and 1 patient in transbracnhial broncholith group, the other 3 transbracnhial broncholiths were partly removed. Complications included perioperative massive hemolysis(=1), bronchoesophageal fistula(=1) and postoperative pneumonia (=2), no long term complications were encounted. The Ho: YAG were associated with acute complications including fistula, perioperative massive hemolysis, infections and no long-term side effects. It represents a safe and effective therapy option for broncholithiasis.
为评估钬激光治疗支气管结石症的有效性。我们回顾性分析了2012年5月至2015年10月在北京大学第一医院接受钬激光碎石术的6例患者的临床资料。纳入4例女性和2例男性，中位年龄为60岁。6例患者中，主要临床症状为持续性咳嗽（2例）、咯血（2例）、反复肺炎（2例）。1例患者支气管结石位于左侧，5例位于右侧。2枚支气管结石位于主支气管，4枚位于段支气管。腔内支气管结石2例，经支气管壁支气管结石4例。所有6例患者均在全身麻醉下经硬质支气管镜接受钬激光治疗（脉冲能量0.8 - 1.2 J，频率5 - 10 Hz，激光光纤365μm），症状均得到缓解。腔内支气管结石组及经支气管壁支气管结石组1例患者的支气管结石完全清除，经支气管壁支气管结石组另外3枚结石部分清除。并发症包括围手术期大量溶血（1例）、支气管食管瘘（1例）和术后肺炎（2例），未发现长期并发症。钬激光与包括瘘、围手术期大量溶血、感染等急性并发症相关，且无长期副作用。它是支气管结石症一种安全有效的治疗选择。
