Jiao Y, Huang Q, Zhang Z H, Lv J R, Yang J, Wu H
Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine,Shanghai.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Dec;30(24):1921-1925. doi: 10.13201/j.issn.1001-1781.2016.24.006.
To assess the efficiency and safety of balloon dilation tracheoplasty technique in the management of acquired subglottic stenosis in children. Twenty-three cases were diagnosed as acquired subglottic stenosis by chest CT scan and bronchoscpy,and received the treatment of the balloon dilatation tracheoplasty.The data about the efficiency,complication and prognosis of the treatment were collected. In the 23 cases,6 of All 11 patients with tracheotomy were decannulated,11 patients were successfully managed without tracheotomy,1 patients received laryngotracheal reconstruction(LTR) surgery, 5 cases were still under observation. The overall response rate was 73.91%.All cases were divided into three stages according to Cotton stage system:1 cases were stage Ⅰ stenosis,6 cases were stage Ⅱ and 16 cases were stage Ⅲ. The response rate was 100.00%,83.33%,and 68.75% respectively. The most common complication in the balloon dilatation tracheoplasty was restenosis. Restenosis occurs in 12(52.17%) cases who received more than 1 dilation procedures in this study. Over all average dilation times is 1.87. Eight cases(88.9%) of 9 in fresh leision group were recoverd, the average dilation time is 1.22; 8 cases (57.14%) of 14 in old leision group were recoverd, the average dilation time is 2.23. The average dilation time between two group is significant(<0.05). Subglottic stenosis in pediatric patients can be successfully managed with balloon dilation tracheoplasty. In patients without prior tracheotomy, tracheotomy can often be safely avoided with appropriate postoperative management.
评估球囊扩张气管成形术治疗儿童获得性声门下狭窄的有效性和安全性。23例经胸部CT扫描和支气管镜检查诊断为获得性声门下狭窄的患儿接受了球囊扩张气管成形术治疗。收集治疗的有效性、并发症及预后等相关数据。23例患儿中,11例气管切开患儿中有6例拔管,11例未行气管切开患儿治疗成功,1例行喉气管重建手术,5例仍在观察中。总有效率为73.91%。所有病例根据Cotton分期系统分为三个阶段:Ⅰ期狭窄1例,Ⅱ期6例,Ⅲ期16例。有效率分别为100.00%、83.33%和68.75%。球囊扩张气管成形术最常见的并发症是再狭窄。本研究中接受1次以上扩张治疗的12例(52.17%)患儿发生再狭窄。总体平均扩张次数为1.87次。新鲜病变组9例中有8例(88.9%)恢复,平均扩张次数为1.22次;陈旧病变组14例中有8例(57.14%)恢复,平均扩张次数为2.23次。两组间平均扩张次数差异有统计学意义(<0.05)。球囊扩张气管成形术可成功治疗小儿声门下狭窄。对于未行气管切开的患儿,适当的术后管理通常可安全避免气管切开。