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32 例声门下良性气道狭窄采用 Montgomery T 型硅酮支架治疗的临床分析。

Clinical Analysis of 32 Cases of Subglottic Benign Airway Stenosis Treated With Montgomery T Silicone Stent.

机构信息

The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Department of Respiratory and Critical Care Medicine, Suzhou 215000, Jiangsu, China.

The First Affiliated Hospital of Soochow University, Department of Respiratory and Critical Care Medicine, Suzhou 215000, Jiangsu, China.

出版信息

Can Respir J. 2024 Oct 16;2024:2145560. doi: 10.1155/2024/2145560. eCollection 2024.


DOI:10.1155/2024/2145560
PMID:39444845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11498979/
Abstract

To explore the complications of long-term placement of Montgomery T silicone stent (Ttube) in the treatment of subglottic benign airway stenosis (SBAS) and the timing of successful Ttube removal. We retrospectively collected the clinical data of 32 patients with SBAS who underwent the treatment of Ttube and analyzed their placement and successful removal of the Ttube. There were 22 males and 10 females, aged from 21 to 79 years (60.9 ± 13.7 years). The Ttubes were successfully placed in all 32 patients, and 6 patients (18.8%) with mild stenosis were placed by the intravenous conscious sedation. The longest follow-up period was 60.4 months, and 17 patients (53.1%) had the Ttubes for more than 12 months; 5 patients (15.6%) were changed to the tracheostomy cannula after unplanned removal of the Ttubes for various reasons; the Ttubes were successfully removed in 9 patients (28.1%), and the duration of Ttubes placement was 5.2-22.7 months (12.1 ± 6.3 months), among them anatomical stenosis in 9 patients (100%). Secretion retention was observed in 32 patients (100%), granulation tissue hyperplasia was observed in 9 patients (28.1%), and the normal ventilation was not affected in most patients by bronchoscopic treatment and follow-up; the Ttubes were removed in 3 patients due to severe complications. There was no significant difference in the incidences of secretion retention and granulation tissue hyperplasia between the time point at 1 week, 1 month, 3 months, and 12 months, > 0.05. In patients with Ttube more than 12 months, the severity of secretion retention at 1 week, 1 month, 3 months, and 12 months was significantly different, < 0.05, however, there was no significant difference in the severity of granulation tissue hyperplasia, > 0.05. Ttube is safe and effective in the treatment of SBAS. The severity of secretion retention increased in patients with long-term placement of the Ttube. For patients with mild stenosis and anatomical stenosis, the Ttube removal can be attempted at about 1 year of follow-up.

摘要

探讨 Montgomery T 硅胶支架(T 管)长期置入治疗声门下良性气道狭窄(SBAS)的并发症及 T 管成功取出的时机。我们回顾性收集了 32 例接受 T 管治疗的 SBAS 患者的临床资料,并分析了 T 管的置入和成功取出情况。患者中男 22 例,女 10 例,年龄 2179 岁,平均(60.9±13.7)岁。32 例患者 T 管均成功置入,其中 6 例(18.8%)轻度狭窄患者采用静脉全麻下置入。最长随访时间 60.4 个月,17 例(53.1%)T 管留置时间超过 12 个月;5 例(15.6%)因各种原因意外拔管后改行气管切开套管;9 例(28.1%)成功取出 T 管,T 管留置时间 5.222.7 个月,平均(12.1±6.3)个月,其中 9 例(100%)为解剖性狭窄。32 例患者均有分泌物潴留(100%),9 例(28.1%)有肉芽组织增生,大多数患者经支气管镜治疗和随访后不影响正常通气;3 例因严重并发症而取出 T 管。1 周、1 个月、3 个月、12 个月时分泌物潴留和肉芽组织增生的发生率差异无统计学意义(均 P>0.05)。T 管留置 12 个月以上患者 1 周、1 个月、3 个月、12 个月时分泌物潴留严重程度的差异有统计学意义(P<0.05),但肉芽组织增生严重程度的差异无统计学意义(P>0.05)。T 管治疗 SBAS 安全有效,长期留置 T 管患者分泌物潴留程度加重。对于轻度狭窄和解剖性狭窄患者,可尝试在随访 1 年左右拔管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/9c97be5908e5/CRJ2024-2145560.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/35ca7aac1f69/CRJ2024-2145560.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/c117c868dd53/CRJ2024-2145560.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/9c97be5908e5/CRJ2024-2145560.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/35ca7aac1f69/CRJ2024-2145560.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/c117c868dd53/CRJ2024-2145560.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8679/11498979/9c97be5908e5/CRJ2024-2145560.003.jpg

相似文献

[1]
Clinical Analysis of 32 Cases of Subglottic Benign Airway Stenosis Treated With Montgomery T Silicone Stent.

Can Respir J. 2024

[2]
[Efficacy and safety of Montgomery T-tube placement for benign complex subglottic tracheal stenosis: a retrospective analysis of 29 cases].

Zhonghua Jie He He Hu Xi Za Zhi. 2021-12-12

[3]
Voice and Airway Outcomes of Montgomery T-tube Placement in Laryngotracheal Stenosis.

J Voice. 2024-11

[4]
Application of Montgomery T-Tube Placement in Treating Cotton-Myer IV Subglottic Airway Atresia after Bi-Level Airway Recanalization.

Comput Math Methods Med. 2021

[5]
Silicone T-tube for complex laryngotracheal problems.

Eur J Cardiothorac Surg. 2002-2

[6]
Role of Montgomery T-tube stent for laryngotracheal stenosis.

Auris Nasus Larynx. 2014-4

[7]
Montgomery T-tube placement in the treatment of benign tracheal lesions.

Eur J Cardiothorac Surg. 2009-8

[8]
Extra-long Montgomery T tube in major airway stenosis.

J Laryngol Otol. 2009-7

[9]
A new technique for T tube insertion in severe subglottic stenosis.

Interact Cardiovasc Thorac Surg. 2011-6

[10]
Complications of silicone Y stents placed due to malignant airway stenosis.

Tuberk Toraks. 2019-3

引用本文的文献

[1]
Global burden of disease for musculoskeletal disorders in all age groups, from 2024 to 2050, and a bibliometric-based survey of the status of research in geriatrics, geriatric orthopedics, and geriatric orthopedic diseases.

J Orthop Surg Res. 2025-2-19

本文引用的文献

[1]
Study on the rationality of small diameter metallic airway stent in treatment of tracheal stenosis in injured rabbits.

J Cardiothorac Surg. 2024-3-5

[2]
More Than 1 Way to Put in A T-Tube: A Review of Different Techniques Used in Insertion of Montgomery T-Tubes.

Ann Otol Rhinol Laryngol. 2024-2

[3]
Laryngotracheal Reconstruction for Subglottic and Tracheal Stenosis.

Otolaryngol Clin North Am. 2023-8

[4]
Myer-Cotton Grade of Subglottic Stenosis Depends on Style of Endotracheal Tube Used.

Laryngoscope. 2023-10

[5]
[Clinical application and progress of airway stent in subglottic stenosis].

Zhonghua Jie He He Hu Xi Za Zhi. 2022-11-12

[6]
Comparison of operation time, efficacy and safety between through-the-scope stent and over-the-while stent in malignant central airway obstruction: a multi-center randomized control trial.

Transl Lung Cancer Res. 2022-8

[7]
A narrative review of new research progress regarding the use of airway stents in benign airway stenosis.

Expert Rev Respir Med. 2022-6

[8]
Laryngotracheal stenosis: Mechanistic review.

Head Neck. 2022-8

[9]
[Efficacy and safety of Montgomery T-tube placement for benign complex subglottic tracheal stenosis: a retrospective analysis of 29 cases].

Zhonghua Jie He He Hu Xi Za Zhi. 2021-12-12

[10]
Duration of stenting with Montgomery T-tubes in severe laryngotracheal stenosis: does it matter?

J Laryngol Otol. 2022-4

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