Balloon dilation combined with cryotherapy in the treatment for subglottic stenosis in infants and young children.

doi:10.7504/ek2014120610

Abstract

Abstract:

Abstract： Objective To study balloon dilatation with cryotherapy under bronchoscope for subglottic stenosis in infants and young children，and to explore the efficacy of this new technology，the timing of treatment and safety. Method From July 2009 to May 2014 in 28 SGS cases aged from 1 month to 3 years， bronchoscopic balloon dilatation treatment with CO2 cryotherapy was performed， and different types of SGS treated by minimal invasi were assessed regarding efficacy, complications and outcome. Results The infant SGS were divided into Ⅰ°~Ⅲ° by severity， and soft membrane SGS and scarring SGS by the causes of stenosis. Ⅰ° SGS included 16 cases, in which 8 cases soft membrane SGS were treated by balloon dilatation effectively， 9 cases after combined treatment; in scarring SGS balloon dilatation was effective in 1 case， 4 cases after combined therapy; Ⅱ° SGS included 8 cases， soft membrane SGS were treated effectively in 2 cases， 4 cases after combined treatment; in scarring SGS balloon dilatation was effective in 1 case， 2 cases after combined therapy; Ⅲ °SGS included 4 cases， 1 case of soft membrane SGS and 1 case of scarring SGS responded well to integrated treatment .Conclusion MSCT and bronchoscopy assessment is used in grading the extent and causes of stratification in infants with subglottic stenosis， and then we can select the appropriate treatment programs to improve the prognosis of the disease and improve life quality of SGS children.

Key words: subglottic stenosis, balloon dilatation tracheoplasty, cryotherapy, bronchoscope

摘要：

目的气管镜下球囊扩张成形术配合冷冻治疗婴幼儿声门下狭窄，并探讨这类新技术的疗效、治疗时机以及安全性。方法　上海儿童医学中心自2009年7月至2014年5月对28例1个月至3岁的SGS患儿进行气管镜下球囊扩张成形术配合二氧化碳（CO2）治疗，并对不同类型声门下狭窄微创治疗的疗效、并发症及转归进行综合分析。结果将婴幼儿声门下狭窄按严重程度分为Ⅰ～Ⅲ度，按照狭窄成因分为蹼样狭窄和疤痕狭窄。其中Ⅰ度狭窄病例16例，其中蹼样狭窄球囊扩张有效8例，综合治疗后有效9例，疤痕狭窄球囊扩张有效1例，综合治疗后有效4例；Ⅱ度狭窄病例8例，蹼样狭窄球囊扩张有效2例，综合治疗后有效4例，疤痕狭窄球囊扩张有效1例，综合治疗后有效2例；Ⅲ度狭窄病例4例，蹼样狭窄综合治疗后有效1例，疤痕狭窄综合治疗后有效1例。结论通过MSCT和气管镜评估，对于婴幼儿声门下狭窄程度和成因进行分级分层，再选择合适治疗方案，有助于改善预后，提高声门下狭窄患儿生存质量。

关键词: 声门下狭窄, 球囊扩张成形术, 二氧化碳冷冻治疗, 气管镜

CLC Number:

Ｒ72

ZHANG Lei*， YIN Yong， ZHANG Jing， ZHANG Hao，WANG Wei，ZHU Ming.. Balloon dilation combined with cryotherapy in the treatment for subglottic stenosis in infants and young children.[J]. Acta Metallurgica Sinica, DOI: 10.7504/ek2014120610.

张磊a，殷勇a，张静a，张皓a，王薇a，朱铭b. 气管镜下球囊扩张术结合冷冻治疗婴幼儿声门下狭窄临床研究[J]. 中国实用儿科杂志, DOI: 10.7504/ek2014120610.

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（2014 - 06 - 25 收稿　2014 - 09 - 12 修回）

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