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可屈性支气管镜下气囊扩张

Author
Henri G Colt, MD
Section Editor
Praveen N Mathur, MB;BS
Deputy Editor
Geraldine Finlay, MD
Translators
肖奎, 副主任医师

引言

近端气道的良性气管支气管狭窄可起因于多种情况，并能引起呼吸困难、咳嗽、哮鸣、喘鸣或反复肺部感染。多种方法可用来处理良性气道狭窄，但没有哪种被证实一律有效[1-5]。本文将总结可屈性气囊扩张术(支气管成形术)治疗良性气道狭窄。治疗这些病变的其他方法将单独讨论。 (参见“中央气道阻塞的诊断与处理”)

首次报道的成功使用气囊扩张良性气道狭窄的案例是1例存在术后狭窄的18周婴儿[6]。对于与以下情况相关的狭窄在随后数年中报道了该技术的数种应用：长期插管[7]、袖套状切除联合支气管再植术[8]、由吸入药片碎片引起的支气管内肉芽肿，以及放疗后复发性鳞状细胞癌[9]。

这些初始报告利用透视或硬管支气管镜来引导扩张操作。直到1991年才出现可屈性支气管镜下气囊扩张的报道[10]，自那时以来，已发布相对较少的报告，而报告的患者数量少[11-19]。

狭窄的病因

亚急性气道损害最常作为支气管肺癌的并发症发生，但在这种情况下气囊扩张术仅能提供有限的舒缓作用[20]。然而，这种技术在治疗由很多情况引起的良性狭窄时有用，包括：

●长期气管内插管或气管切开术的后遗症[12]

            

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Literature review current through: 2017-07 . | This topic last updated: 2015-10-04.
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