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目的探讨支气管镜下电凝治疗儿科气道管腔内肉芽形成、纤维组织增生导致气道狭窄及咽喉部占位性病变压迫气道引起通气不畅的疗效和安全性。方法对2009年9月至2011年6月山东大学齐鲁儿童医院呼吸介入科收治的12例气道内增生病变患儿,其中支气管异物后气道内增生3例、支气管内膜结核菌感染引起黏膜肉芽生长阻塞气道所致肺不张2例、气管插管后气管黏膜纤维组织增生导致气管狭窄出现呼吸困难5例、舌根部囊肿压迫会厌致会厌抬起受限而引起呼吸困难2例。实施支气管镜下电凝治疗。分别于术前和最后1次电凝治疗后对病变部位进行支气管镜下评估,胸部CT及肺功能检查,对肺不张及通气功能进行评价。结果 12例患儿分别接受电凝治疗(共13次),其中显效11例、有效1例,有效率100%,未见并发症发生。结论支气管镜下电凝治疗对于异物、感染后肉芽组织生长阻塞气道形成的肺不张、气管插管后气道内膜纤维组织增生性气管狭窄以及咽喉部占位性病变压迫气道形成的呼吸困难,是快速、有效的治疗方法,但手术操作有风险,需经技术培训。
Objective To investigate the efficacy and safety of bronchoscopic electrocoagulation for the treatment of granulomas in the pediatric airway lumen, hyperplasia of the airway leading to airway stenosis and laryngeal space-occupying lesion-induced airway obstruction. Methods From September 2009 to June 2011, 12 children with airway hyperplasia were enrolled in the Department of Respiratory Intervention, Qilu Children’s Hospital of Shandong University. Among them, 3 cases of airway hyperplasia after bronchial foreign body, and bronchial intimal mucosal infection caused mucosal granulation growth 2 cases of obstruction caused by airway atelectasis, tracheal intubation, tracheal mucosa caused by fibrous tissue proliferation of tracheal stenosis in 5 cases of dyspnea, tongue root cyst oppression caused by epiglottis caused by limited lifting caused by dyspnea in 2 cases. The implementation of bronchoscopic coagulation therapy. Bronchoscopy, chest CT and pulmonary function tests were performed on the lesion site before and after the last electrocoagulation. The atelectasis and ventilatory function were evaluated. Results 12 cases were treated with electrocoagulation (13 times), 11 cases were markedly effective and 1 case was effective. The effective rate was 100%. No complication occurred. Conclusions Bronchoscopic electrocoagulation is an effective and safe method for the treatment of foreign body, atelectasis caused by obstruction of airway during the growth of granulation tissue after infection, airway stenosis of airway endometrial fibrous tissue after tracheal intubation and compressed airway of pharyngeal space occupying lesion Dyspnea is a fast and effective treatment, but surgical procedures are risky and require technical training.