Yang Mingyuan, Li Hong, Zhou Yunzhi, Wei Huafeng, Cheng Qinghao
Center of Anesthesiology and Pain Emergency General Hospital Beijing China.
Department of Pulmonary and Critical Care Medicine Emergency General Hospital Beijing China.
Laryngoscope Investig Otolaryngol. 2024 Aug 21;9(4):e70002. doi: 10.1002/lio2.70002. eCollection 2024 Aug.
With advancements in respiratory interventional techniques, bronchoscopic intervention technology has emerged as a viable approach for managing postintubation tracheal stenosis (PITS). However, there was a paucity of research investigating the potential impact of stenosis characteristics and morphology (such as stenosis degree, length, type, and morphology) on bronchoscopic intervention treatment prognosis for PITS patients. This study was to assess the impact of various preoperative stenosis characteristic factors on the bronchoscopic cure rate among patients.
This is a retrospective study analyzing the medical records of patients with PITS who received bronchoscopic intervention at the tertiary interventional pulmonology center.
Among the cases, 115 individuals achieved a in a success rate of 79.86% for bronchoscopic intervention therapy and were assigned to Group S. On the other hand, 29 cases required surgical intervention, accounting for a surgical treatment rate of 20.14% and were assigned to Group F. The stenosis in the Group F predominantly exhibited irregular shapes with scar granulation accompanied by tracheal chondromalacia collapse. Patients in group S experienced fewer total procedures, rigid bronchoscopy treatment, intraoperative hypoxemia, needed emergency re-bronchoscopy in 24 h and transferred to ICU postoperatively. Patients with pure scar and granuloma, the rate of bronchoscopic success cure was higher than patients with scar granulation accompanied by tracheal chondromalacia (odds ratio: 8.208; 95% confidence interval: 2.755-24.459), and regular stenosis morphology was associated with a higher bronchoscopic success cure rate (odds ratio: 9.463; 95% confidence interval: 3.128-28.623).
Irregular airway stenosis, chondromalacia or airway collapse are key factors affecting the success rate of bronchoscopic treatment for post-intubation tracheal stenosis. : 4 (historically controlled studies).
随着呼吸介入技术的进步，支气管镜介入技术已成为治疗插管后气管狭窄（PITS）的一种可行方法。然而，关于狭窄特征和形态（如狭窄程度、长度、类型和形态）对PITS患者支气管镜介入治疗预后的潜在影响的研究较少。本研究旨在评估各种术前狭窄特征因素对患者支气管镜治愈率的影响。
这是一项回顾性研究，分析在三级介入肺科中心接受支气管镜介入治疗的PITS患者的病历。
在这些病例中，115例患者支气管镜介入治疗成功率为79.86%，被分配到S组。另一方面，29例患者需要手术干预，手术治疗率为20.14%，被分配到F组。F组的狭窄主要表现为不规则形状，伴有瘢痕肉芽组织，并伴有气管软骨软化塌陷。S组患者的总手术次数、硬质支气管镜治疗次数、术中低氧血症较少，24小时内需要紧急再次支气管镜检查的情况较少，术后转入重症监护病房的情况也较少。单纯瘢痕和肉芽肿患者的支气管镜成功治愈率高于伴有气管软骨软化的瘢痕肉芽组织患者（优势比：8.208；95%置信区间：2.755 - 24.459），规则的狭窄形态与较高的支气管镜成功治愈率相关（优势比：9.463；95%置信区间：3.128 - 28.623）。
气道狭窄不规则、软骨软化或气道塌陷是影响插管后气管狭窄支气管镜治疗成功率的关键因素。：4（历史对照研究）
