Department of Respiratory Medicine, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi'an Medical University, Xi'an, China.
Intern Emerg Med. 2021 Oct;16(7):1865-1871. doi: 10.1007/s11739-020-02531-9. Epub 2020 Oct 23.
The purpose of this study is to report our experiences over 12 years with bronchoscopic interventions in patients with benign central airway stenosis using three types of working channels (rigid bronchoscope, laryngeal mask, and endotracheal intubation), with a focus on their related advantages, disadvantages, and postoperative complications. We analyzed the clinical data from 273 patients with benign central airway stenosis who underwent a bronchoscopic intervention. The Wilcoxon rank-sum test was used to analyze the immediate results after the first bronchoscopic intervention, and the Chi-square test was used to analyze the correlation between glottic edema and operation time. The 273 patients underwent a total of 479 bronchoscopic interventions, with satisfactory results. The immediate effective rates of the first bronchoscopic intervention by rigid bronchoscope, laryngeal mask, and endotracheal intubation were 91.4%, 91.3%, and 85.2%, respectively. Postoperative complications related to the working channels included hoarseness, glottic edema, pharyngalgia, paresthesia pharynges, cough, and tooth loss. Glottic edema was the most serious complication, and it occurred in 37.7% (23/61) of the rigid bronchoscope group and 9.8% (32/326) in the laryngeal mask group. And the incidence rate was significantly correlated with the operation time (P < 0.01). Therefore, for patients with benign central airway stenosis, the best choice of working channel during an operation should be made by the operation procedure, lesion location, and pathology of the patients. Shortening the operation time was an important factor in preventing glottic edema.
本研究旨在报告我们在过去 12 年中使用三种工作通道（硬性支气管镜、喉罩和气管插管）对良性中央气道狭窄患者进行支气管镜介入治疗的经验，重点介绍其相关优点、缺点和术后并发症。我们分析了 273 例良性中央气道狭窄患者行支气管镜介入治疗的临床资料。采用 Wilcoxon 秩和检验分析首次支气管镜干预后的即刻结果，采用卡方检验分析声门水肿与手术时间的相关性。273 例患者共行 479 次支气管镜介入治疗，效果满意。硬性支气管镜、喉罩和气管插管首次支气管镜干预的即刻有效率分别为 91.4%、91.3%和 85.2%。与工作通道相关的术后并发症包括声音嘶哑、声门水肿、咽痛、咽感觉异常、咳嗽和牙齿脱落。声门水肿是最严重的并发症，在硬性支气管镜组中发生率为 37.7%（23/61），在喉罩组中发生率为 9.8%（32/326），且发生率与手术时间显著相关（P < 0.01）。因此，对于良性中央气道狭窄患者，应根据手术程序、病变位置和患者病理选择最佳的工作通道。缩短手术时间是预防声门水肿的重要因素。
