40例主气道狭窄患者诊治体会

目的 探讨主气道狭窄患者的病因及选择适当的治疗方式.方法 收集吉林大学第二医院40例主气道狭窄患者的病因,并观察其选择不同治疗方式的效果.结果 40例主气道狭窄患者中,总气管肿物15例(37.5％),气管内膜结核11例(27.5％),气管插管及切开后9例(22 5％),气管黏膜炎症3例(7.5％),气管淀粉样变1例(2.5％),食管癌术后放疗1例(2.5％).在治疗方式的选择上,除外保守治疗(19例),选择气管切开9例,球囊扩张6例,T管置入5例,冷冻治疗7例,氩气刀治疗6例.接受气管切开、球囊扩张、T管置入、冷冻治疗及氩气刀治疗的患者呼吸困难等症状均得到明显减轻.结论 气管插管及切开造成主气道狭窄的发病率有所上升.患者通过气管切开可迅速缓解症状,联合介入技术及T管置入术已成为除外外科手术治疗的有效方式.

Experience in diagnosis and treatment of 40 patients with primary airway stenosis

Objective To explore the causes of primary airway stenosis and to choose appropriate treatment modes.Methods The causes of 40 patients with primary airway stenosis in the Second Hospital of Jilin University were collected,and the effects of different treatment modes were observed.Results Among the 40 patients with primary airway stenosis,15 patients (37.5％) had a lump in the trachea,11 patients(27.5 ％) had tuberculosis,nine patients (22.5 ％) underwent tracheal intubation and incision,three patients (7.5 ％) had tracheal mucosal inflammation,one patient (2.5 ％) had tracheal amyloidosis,and one patient (2.5 ％) underwent had radiotherapy after operation for esophageal cancer.In terms of treatment modes,except for 19 patients who were given conservative treatment,nine patients were given tracheotomy,six patients were given balloon dilatation,five patients were given T-tube insertion,seven patients were given cryotherapy,and six patients were given argon knife treatment.The symptoms like dyspnea of patients who had accepted tracheotomy,balloon dilatation,T-tube insertion,cryotherapy and argon knife therapy all relieved obviously.Conclusions Tracheal intubation and tracheotomy both make the morbidity of airway stenosis increase.The symptoms can be rapidly relieved through tracheotomy.The combination of intervention techniques and T tube implantation has already become an effective method besides surgical procedures.