联合介入方法治疗良性瘢痕增生性气道狭窄的疗效分析

目的初步探讨在狭窄部位局部注射丝裂霉素C治疗良性瘢痕增生性气道狭窄的安全性和疗效。方法良性瘢痕增生性狭窄患者24例,对照组16例,丝裂霉素组8例。对照组采用单纯支气管镜下介入治疗。丝裂霉素组采用介入方法联合狭窄局部注射丝裂霉素C(浓度为0.4 mg/ml,给药剂量按狭窄长度计算,1 ml/cm),给药方法为气管镜下黏膜针注射。随访6个月,观察狭窄气道内局部注射丝裂霉素的安全性及疗效。结果两组患者治疗后气道直径、气促指数均明显改善,差异有统计学意义。两组治疗后气道直径增加值均显示丝裂霉素治疗组效果好,差异有统计学意义。对照组与丝裂霉素组6个月内平均每例介人治疗次数为(4.94±1.18)次和(2.63±0.74)次,差异有统计学意义。丝裂霉素组患者在观察期内均未出现与药物相关的并发症。结论局部注射丝裂霉素联合常规介入方法,可明显延长良性瘢痕增生性气道狭窄再狭窄的时间,安全性好。

Effect and safety of bronchoscopic convention interventional modalities for hypertrophic benign central air-way stenosis

Objective To comparatively analyze the safety and efficacy of local injection of mitomycin C in a narrow place treating benign central airway cicatricial hyperplastic stenosis. Methods 24 patients with benign cicatricial hyperplastic stenosis were divided into the control group（ n = 16） and the MMC group（ n = 8）. The control group was given merely bronchoscopic interventional therapy,and the MMC group was treated with intervention method mentioned above with local injection of mitomycin C（ concentration of 0. 4mg /ml,dosage according to the stricture length calculation,1ml /cm） in the narrow part. They were followed-up for 6 months,and the safety and efficacy were observed. Results After the treatment,their gas channel diameter and dyspnea index were significantly improved with statistical significance. The mean referral times of each patient in the control group and the MMC group in6 months were 4. 94 ± 1. 18 and 2. 63 ± 0. 74 respectively. There was no drug-related complications in the observation period. Conclusion Local injection of mitomycin C combined with conventional respiratory intervention method can obviously prolong the restenosis time of benign central airway cicatricial hyperplastic stenosis and has a high security.