气管支架置入术——气管狭窄的一种新型治疗方式

文献信息

中文摘要

引言： 气管狭窄被定义为气管的病理性狭窄。气管狭窄可由多种因素引起，但气管内插管和气管切开术是获得性良性气管狭窄最常见的原因。由于炎症或瘢痕组织导致的气道狭窄会损害正常呼吸，并可能易患上、下呼吸道感染。气管狭窄的治疗目标是恢复通畅的气道和声门功能。
目的： 确定Dumon支架治疗气管狭窄的疗效和并发症特征。
方法： 一项观察性前瞻性队列研究于2018年1月至2023年12月在一家三级医疗中心进行。所有因插管后、气管切开术后或腐蚀性酸摄入导致气管狭窄的患者均被纳入考虑。获取完整病史，随后进行体格检查和必要的检查。
结果： 研究对象的平均年龄为22.5岁，并注意到男性占多数（60.7%）。气管狭窄最常见的原因被发现是气管内插管（57.1%）。Dumon支架置入术未出现肉芽组织形成、瘢痕形成或再狭窄等并发症。
结论： 插管后气道狭窄是气管狭窄最常见的原因。手术治疗是气管狭窄的确定性治疗。在本研究中，Dumon支架未显示复发。这些发现表明，Dumon支架置入术是喉气管端端吻合术的一种安全且可行的替代方案。

英文摘要

INTRODUCTION: Tracheal stenosis is defined as pathological narrowing of the trachea. Tracheal stenosis can be caused by various factors but endotracheal intubation and tracheostomy are the most common causes of acquired benign tracheal stenosis. Airway narrowing due to inflammation or scar tissue impairs normal breathing and may predispose to upper and lower respiratory infections. The Goal of treatment for tracheal stenosis is to restore a patent airway and glottic competence.
OBJECTIVE: To determine the efficacy and complication profile of Dumon's stent in treatment for tracheal stenosis.
METHODS: An observational prospective cohort study was conducted at a tertiary care center from January 2018 to December 2023. All patients presenting with tracheal stenosis resulting from post-intubation, post-tracheostomy, or corrosive acid ingestion were considered. A complete history was obtained followed by physical examination and necessary investigations.
RESULTS: Mean age of study subjects was 22.5 years and male preponderance (60.7%) was noted. Most common cause of tracheal stenosis was found to be endotracheal intubation (57.1%). Dumon stent placement demonstrated no complications such as granulation tissue formation, scarring or restenosis.
CONCLUSION: Post-intubation airway stenosis is the most common cause of tracheal stenosis. Surgical management is the definitive treatment for tracheal stenosis. In this study, Dumon's stent showed no recurrences. These findings suggest that Dumon stent placement is a safe and viable alternative to laryngotracheal end-to-end anastomosis.