Etiology，Diagnosis and Treatment of 84 Children with Central Airway Stenosis
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摘要:
目的 分析儿童中心气道狭窄疾病的病因构成、形态分类，探讨其诊疗方法。 方法 回顾性收集2017年08月至2020年08月收治住院的中心气道狭窄患儿84例的临床资料，男54例，女30例，年龄20 d～14岁，其中婴幼儿为64例（76%，64/84）。通过CT及电子支气管镜等检查明确患儿中心气道狭窄的病因及形态特点并制定以经电子 气管镜介入为主的治疗方法。 结果 从病因构成分析：（1）绝大多数为结构性狭窄（88.1% ，74/84），少数为动力性狭窄（11.9%，10/84）；（2）单纯左、右主支气管狭窄最多见（54.8%，46/84），其次是声门下狭窄（23.8%，20/84），最少见的是隆突狭窄（2.4%，2/84）；（3）狭窄程度为76%～90%的病例最常见（54.8%，46/84）；（4）狭窄长度1～3 cm的病例最常见（57.1%，48/84）。84例中16例未干预治疗接受随访观察，随访观察中病情稳定；50例接受了经电子支气管镜介入治疗，治疗均有效。 结论 中心气道狭窄可分布于全年龄段儿童，其病因构成、形态学分类通过CT及电子支气管镜检查基本可以明确。儿童中心气道狭窄以结构性、良性为主。经电子支气管镜介入治疗是儿童中心气道狭窄的主要治疗方法。 Abstract:Objective To analyze the etiology and morphological classification of children with central airway stenosis, and to explore the diagnosis and treatment methods. Methods Clinical data of 84 children with central airway stenosis hospitalized from August 2017 to August 2020 were retrospectively collected, including 54 males and 30 females; aged 20d to 14 years, and there are 64 infants （76%, 64/84）. Through CT and electronic bronchoscopy, the etiology and morphological characteristics of the children's central airway stenosis were determined, and the treatment based on electronic bronchoscopy was developed. Results （1） Majority of them were structural stenosis （88.1%, 74/84）, and a few were dynamic stenosis （11.9%, 10/84）. （2） The most common stenosis was left and right main bronchial stenosis （54.8%, 46/84）, followed by subglottic stenosis （23.8%, 20/84）, and carina stenosis （2.4%, 2/84） （3） 76% to 90% stenosis of was the most common （54.8%, 46/84）. （4） Stenosis of 1-3cm was the most common （57.1%, 48/84）. 16 of the 84 cases received follow-up observation without intervention treatment, and their conditions were stable during follow-up observation. 50 patients received electronic bronchoscope intervention therapy, the treatment was effective. Conclusion Central airway stenosis can be reported in children of all ages, and its etiology and morphological classification can be basically determined by CT and electronic bronchoscopy examination. The central airway stenosis in children was mainly structural and benign. Interventional therapy via electronic bronchoscope is the main treatment for central airway stenosis in children. -
Key words:
- Central airway /
- Stenosis /
- Treatment /
- Electronic bronchoscope /
- Children
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图 1 声门下狭窄介入治疗病例
A：为声门下狭窄治疗前；B：钬激光松解瘢痕组织；C：球囊导管扩张声门下狭窄段；D：球囊扩张后狭窄段改善明显，冷冻肉芽组织；E：气管动力性狭窄；F：气管外压性狭窄，软化环已变形；G：声门下瘢痕性狭窄；H：气管支气管结核病例左主支气管瘢痕性狭窄；I：右主支气管内的肿瘤；J：动静脉瘘病例右主支气管内的肿物；K：气道重建提示声门下狭窄；L：增强CT诊断肺动脉吊带 。
Figure 1. Cases of subglottic stenosis treated by interventional therapy
表 1 84例中心气道狭窄病例形态分类列表 [n（%）]
Table 1. Morphological classification list of 84 patients with central airway stenosis[n（%）]
分类 3141 1532 2542 1543 5222 5232 2222 1542 5322 2522 1233 数量及比例 20（23.8） 18（21.4） 12 （14.3） 12 （14.3） 4 （4.8） 4 （4.8） 4 （4.8） 4 （4.8） 2 （2.4） 2 （2.4） 2 （2.4） 
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