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气管插管保护下应用可弯曲支气管镜对声门下病变进行活检及介入治疗。

Biopsy and interventional therapy of subglottic lesions with flexible bronchoscope under protection of endotracheal intubation.

作者信息

Lin Huihui, Ji Tingfen, Zheng Hao, Ma Wenjiang, Song Shengwen, Zheng Yueying, Yu Danjuan, Ye Lijing, Li Hequan

机构信息

Department of Respiratory Diseases, The First Affiliated Hospital of Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.

Department of General Practice, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.

出版信息

Eur J Med Res. 2025 Apr 28;30(1):337. doi: 10.1186/s40001-025-02615-2.

Abstract

Subglottic lesions represent a complex and challenging clinical entity, often associated with high procedural risks due to their anatomical location and vascularity. While a laryngeal mask airway (LMA) is commonly employed for airway management in such cases, it has notable limitations, particularly in scenarios involving significant bleeding or the need for extended intervention. This article presents an alternative and effective approach for the biopsy and interventional treatment of subglottic lesions using a flexible bronchoscope under the protection of an endotracheal tube (ETT). By inserting the bronchoscope through the space between the ETT and the tracheal wall, various procedures-including biopsy, argon plasma coagulation (APC), and CO₂ cryotherapy-can be performed with relative safety. This method provides a feasible option for airway protection, bleeding control, and lesion management, offering new possibilities in clinical practice.

摘要

声门下病变是一个复杂且具有挑战性的临床实体,由于其解剖位置和血管分布,往往伴随着较高的手术风险。虽然在这类病例中,喉罩气道(LMA)常用于气道管理,但它有显著的局限性,特别是在涉及大量出血或需要长时间干预的情况下。本文介绍了一种在气管内插管(ETT)保护下,使用可弯曲支气管镜对声门下病变进行活检和介入治疗的替代且有效的方法。通过将支气管镜插入ETT与气管壁之间的间隙,可以相对安全地进行各种操作,包括活检、氩等离子体凝固(APC)和CO₂冷冻治疗。该方法为气道保护、出血控制和病变管理提供了一种可行的选择,为临床实践带来了新的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e14/12036187/45c2b18f24a6/40001_2025_2615_Fig1_HTML.jpg

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