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气管插管后声门下狭窄:细胞和分子水平的病因学。

Post-intubation subglottic stenosis: aetiology at the cellular and molecular level.

机构信息

National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland

School of Medicine, University College Dublin, Dublin, Ireland.

出版信息

Eur Respir Rev. 2021 Jan 19;30(159). doi: 10.1183/16000617.0218-2020. Print 2021 Mar 31.

Abstract

Subglottic stenosis (SGS) is a narrowing of the airway just below the vocal cords. This narrowing typically consists of fibrotic scar tissue, which may be due to a variety of diseases. This review focuses on post-intubation (PI) SGS. SGS can result in partial or complete narrowing of the airway. This narrowing is caused by fibrosis and can cause serious breathing difficulties. It can occur in both adults and children. The pathogenesis of post-intubation SGS is not well understood; however, it is considered to be the product of an abnormal healing process. This review discusses how intubation can change the local micro-environment, leading to dysregulated tissue repair. We discuss how mucosal inflammation, local hypoxia and biomechanical stress associated with intubation can promote excess tissue deposition that occurs during the pathological process of SGS.

摘要

声门下狭窄(SGS)是声带以下气道的狭窄。这种狭窄通常由纤维性瘢痕组织组成,可能是由多种疾病引起的。本综述重点介绍了插管后(PI)的 SGS。SGS 可导致气道部分或完全狭窄。这种狭窄是由纤维化引起的,可能导致严重的呼吸困难。它可发生在成人和儿童中。插管后 SGS 的发病机制尚不清楚;然而,它被认为是异常愈合过程的产物。本综述讨论了插管如何改变局部微环境,导致组织修复失调。我们讨论了与插管相关的粘膜炎症、局部缺氧和生物力学应激如何促进 SGS 病理过程中过度的组织沉积。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22f3/9489001/51e2c11e3540/ERR-0218-2020.01.jpg

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