中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2012年
6期
415-418
,共4页
曲安奈德%局部注射%良性气道狭窄%难治性
麯安奈德%跼部註射%良性氣道狹窄%難治性
곡안내덕%국부주사%량성기도협착%난치성
Triamcinolone acetonide%Local injection%Benign airway stenosis%Recalcitrant
[目的]初步探讨在狭窄部位局部注射曲安奈德治疗难治性中央气道狭窄的疗效和安全性.[方法]2008年1月至2010年12月广州医学院第一附属医院就诊的难治性良性中央气道狭窄患者20例,其中男10例,女10例,年龄(40±16)岁,给予常规介入方法结合局部注射曲安奈德治疗；同期纳入常规介入方法治疗的20例难治性气道狭窄患者作为对照,其中男7例,女13例,年龄(36±17)岁.比较2组患者的疗效和安全性,随访6～18个月观察远期疗效.[结果]2组患者治疗后气道直径、横截面狭窄率、气促指数均明显改善,两组近期疗效没有明显区别(P＞0.05)；曲安奈德治疗组再狭窄的治疗间隔时间由术前的(11±5)d增加到术后的(99±56)d,20例中16例病情稳定,4例发生再狭窄需再次治疗.对照组再狭窄的治疗间隔时间为(11±4)d,两组比较差异有统计学意义(P＜0.01).治疗组治疗前后血浆皮质醇及空腹血糖水平均在正常范围,无明显波动,未出现糖皮质激素局部注射的相关并发症.[结论]局部注射曲安奈德联合常规呼吸介入方法,可明显延长难治性良性中央气道狭窄再狭窄的时间,安全性较高.
[目的]初步探討在狹窄部位跼部註射麯安奈德治療難治性中央氣道狹窄的療效和安全性.[方法]2008年1月至2010年12月廣州醫學院第一附屬醫院就診的難治性良性中央氣道狹窄患者20例,其中男10例,女10例,年齡(40±16)歲,給予常規介入方法結閤跼部註射麯安奈德治療；同期納入常規介入方法治療的20例難治性氣道狹窄患者作為對照,其中男7例,女13例,年齡(36±17)歲.比較2組患者的療效和安全性,隨訪6～18箇月觀察遠期療效.[結果]2組患者治療後氣道直徑、橫截麵狹窄率、氣促指數均明顯改善,兩組近期療效沒有明顯區彆(P＞0.05)；麯安奈德治療組再狹窄的治療間隔時間由術前的(11±5)d增加到術後的(99±56)d,20例中16例病情穩定,4例髮生再狹窄需再次治療.對照組再狹窄的治療間隔時間為(11±4)d,兩組比較差異有統計學意義(P＜0.01).治療組治療前後血漿皮質醇及空腹血糖水平均在正常範圍,無明顯波動,未齣現糖皮質激素跼部註射的相關併髮癥.[結論]跼部註射麯安奈德聯閤常規呼吸介入方法,可明顯延長難治性良性中央氣道狹窄再狹窄的時間,安全性較高.
[목적]초보탐토재협착부위국부주사곡안내덕치료난치성중앙기도협착적료효화안전성.[방법]2008년1월지2010년12월엄주의학원제일부속의원취진적난치성량성중앙기도협착환자20례,기중남10례,녀10례,년령(40±16)세,급여상규개입방법결합국부주사곡안내덕치료；동기납입상규개입방법치료적20례난치성기도협착환자작위대조,기중남7례,녀13례,년령(36±17)세.비교2조환자적료효화안전성,수방6～18개월관찰원기료효.[결과]2조환자치료후기도직경、횡절면협착솔、기촉지수균명현개선,량조근기료효몰유명현구별(P＞0.05)；곡안내덕치료조재협착적치료간격시간유술전적(11±5)d증가도술후적(99±56)d,20례중16례병정은정,4례발생재협착수재차치료.대조조재협착적치료간격시간위(11±4)d,량조비교차이유통계학의의(P＜0.01).치료조치료전후혈장피질순급공복혈당수평균재정상범위,무명현파동,미출현당피질격소국부주사적상관병발증.[결론]국부주사곡안내덕연합상규호흡개입방법,가명현연장난치성량성중앙기도협착재협착적시간,안전성교고.
Objective To evaluate the efficacy and security of local injection of triamcinolone acetonide(TA)combined multiple convention interventional procedures for benign central airway stenosis (BAS).Methods Forty patients with intractable benign central airway restenosis after treated by repeatedly traditional interventional treatment in our hospital between January 2008 to December 2010 were retrospectively analyzed.Forty intractable BAS patients were selected and averagely divided into treatment group and control group.Local injection of TA was uesd to cover entire stenosis lesions.Two or more procedures were combined to manage complicated airway stenosis.After a 6 months follow-up,compared to before and after the treatment of airway diameter,airway stricture rate,dyspnea score,interphase of interventional treatment and clinical stabilization,fasting blood glucose,plasma cortisol,injection local mucosal and clinical symptoms,evaluated its curative effect and side effect.Result Twenty cases of treatment group patients with intractable benign central airway stenosis were treated.After 6 to 18 months follow-up,16 patients remain stable after treatment,besides 4 patients appear restenosis.16 patients,did not appear restenosis; 4 patients appear restenosis.Restenosis interphase time or Clinical stationary time was increased from(10.95±5.49)days before the therapy to(98.75±55.58)days after therapy of local injection of TA(P＜0.01).The long-term outcome,the control group 20 cases restenosis in a 6 months follow-up time.After 6 months the the airway diameter of treatment group is(8.70±2.52)mm compared with control group(4.50±1.64)mm,(P＜0.01);the airway narrow rate of treatment group is(29.17±14.55)％,compared with control group(64.80±13.35)％,(P＜0.01); breathlessness score of treatment group is(0.55±0.76),compared with control group(2.70±0.92,P＜0.01),with statistically significant difference.None of the twenty patients appear local injections related complications,observation period,cortisol levels remain normal without glucocorticoids related serious complications.Conclusion Local injections of TA therapy combined with traditional interventional techniques for BAS has good curative effect and safety.
