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目的:探讨再次气管狭窄患者的临床特点及T型管的应用价值。方法:对14例再次气管狭窄患者行气管造口下内镜和支撑喉镜进路,气管狭窄处理并用T型管置入,并留置6个月以上,随访患者1年以上,用电子喉镜评价患者气管狭窄康复情况。结果:气管狭窄的长度0.5mm至44mm,平均24mm,9例患者均为膜性狭窄。其中轻度狭窄5例,中度6例,重度狭窄3例。离气管隆突距离为4mm～54mm,平均26mm,其中6例均在距气管隆突20mm范围内,以气管插管病例为主。所有患者均未行狭窄段气管切除,均行狭窄段气管扩张或瘢痕切除,T管置入。平均带管时间为6.2月。拔出T管半年以上,所有患者气管腔内未见明显狭窄出现,1例残留有肉芽在原气管造口愈合处。结论:患者均需较长时间带管,需二次手术取出为其缺点,T管留置治疗再次气管狭窄失败率较低,疗效可靠。
Objective: To investigate the clinical features of patients with recurrent tracheal stenosis and the value of T-tube. Methods: Twenty-four patients with re-tracheal stenosis underwent endotracheal and endoscopic laryngoscopy, tracheal stenosis and T-tube insertion. The patients were left for more than 6 months. Patients were followed up for more than 1 year. Evaluation of patients with tracheal stenosis rehabilitation. Results: Tracheal stenosis length 0.5mm to 44mm, an average of 24mm, 9 patients were membranous stenosis. Among them, 5 were mild stenosis, 6 were moderate stenosis and 3 were severe stenosis. The distance from the tracheal carina was 4mm ~ 54mm, an average of 26mm, of which 6 cases were within 20mm from the tracheal carina, tracheal intubation cases. All patients were not stenotic tract tracheotomy, tracheal stenosis or scar resection, T tube into. The average tube time is 6.2 months. Pull out the T-tube more than six months, all patients showed no obvious stenosis in the tracheal cavity, 1 case of residual granulation in the original tracheostomy healing. Conclusion: All the patients need to take a long time to take the tube, take the second surgery for its shortcomings, T tube indwelling re-tracheal stenosis failure rate is lower, the curative effect is reliable.