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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2025年02期

页码:

315-320

栏目:

论著

出版日期:

2025-04-25

文章信息/Info

Title:

Clinical application of holmium laser via bronchoscopy in patients with central airway obstruction

作者:

林敏杰¹; 吕艳玲¹; 姚 羽¹; 王艳泓²; 邹如意³; 唐 成⁴

210000 南京,南京中医药大学附属南京医院(南京市第二医院)呼吸和危重症医学科¹；223001 淮安,淮安市肿瘤医院呼吸和危重症医学科²；210000 南京,南京大学医学院附属鼓楼医院呼吸和危重症医学科³；412000 株洲,株洲二医院呼吸和危重症医学科⁴

Author(s):

Lin Minjie¹;  Lv Yanling¹;  Yao Yu¹;  Wang Yanhong²;  Zou Ruyi³;  Tang Cheng⁴.

¹Department of Pulmonary and Critical Care Medicine, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210000, China; ²Department of Pulmonary and Critical Care Medicine, Huai'an Cancer Hospital, Huai'an 223001, China; ³Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing 210008, China; ⁴Department of Pulmonary and Critical Care Medicine, The Second Hospital of Zhuzhou, Zhuzhou 412000, China

关键词:

中心气道狭窄;  钬激光;  支气管镜;  临床应用

Keywords:

Central airway obstruction;  Holmium laser;  Bronchoscope;  Clinical application

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2025.02.021

摘要:

目的 分析支气管镜下钬激光治疗中心气道狭窄(central airway obstruction, CAO)患者的临床疗效及安全性,探讨该技术治疗不同病因致狭窄的作用,为临床提供参考。方法 选择2017年12月至2023年8月我院收治的7例因不同病因致中心气道狭窄患者。患者接受支气管镜下钬激光治疗。分析治疗过程中的安全性、疗效及钬激光在治疗中的作用。 结果 7例中心气管狭窄患者中女2例,男5例,年龄57～69岁,平均年龄(65.43±6.32)岁。良性中心气道狭窄4例,恶性狭窄3例。狭窄部位分布于主气管2例,主支气管或中间支气管5例。原发病因包括错构瘤1例、气管切开术后狭窄1例、支气管异物1例、支气管结石1例及肺癌致中心气道狭窄3例。患者经支气管镜下钬激光治疗,治疗过程中少量出血,未发生气胸或感染等并发症。治疗后胸闷气促、咳嗽、咳痰等症状减轻或消失。结论 支气管镜下钬激光治疗多种病因致中心气道狭窄较其他治疗技术具有去除病变速度快和术野清晰等优势,有利于消融骨性异物及破坏移位支架等,治疗过程安全性好,适用于良性和恶性病变治疗。

Abstract:

Objective To analyze the efficacy and safety of bronchoscopic holmium laser in the treatment of central airway obstruction(CAO)while investigating its distinctive role in obstruction caused by various diseases, thus providing valuable insights for clinicians when applying this technique. Methods All of 7 patients with central airway obstruction caused by various etiologies selected from Zhuzhou Second Hospital between December 2017 and August 2023. These patients were all treated with bronchoscopic holmium laser therapy, and it was analyzed these cases carefully to evaluate the safety and efficacy of this treatment method in central airway obstruction. Results The patients consisted of 2 females and 5 males, Age 57～69 years old,with an average age of(65.43±6.32)years. Based on etiology, benign central airway obstruction was observed in 4 patients, while malignant central airway obstruction was present in 3 patients. Obstruction lesions involved the trachea 2 cases as well as the main or intermediate bronchus 5 cases. The primary etiologies encompassed a diverse range including hamartoma 1 case, post-tracheotomy stenosis 1 case, bronchial foreign body 1 case, bronchial calculus 1 case, and central airway obstruction due to lung cancer 3 cases. The patient was treated with holmium laser under bronchoscopy. There was a small amount of bleeding during the treatment, and no complications such as pneumothorax or infection occurred. After treatment, the symptoms such as chest tightness, shortness of breath, cough and expectoration were alleviated or disappeared. Conclusion Bronchoscopic holmium laser therapy has several advantages in the treatment of central airway obstruction such as rapid removal of lesions and clear surgical field, in particular, it plays an irreplaceable role in ablating bony foreign bodies and destroying dislocated stent, and it is safe in the treatment process. Notably, this technology is suitable for treating both benign and malignant lesions, holding significant value as a therapy option.

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备注/Memo

备注/Memo:

基金项目: 国家自然科学基金资助项目(82203561)
南京市第二医院人才托举工程资助项目(RCMS24003)
株洲市科学技术局社会化出资项目
通信作者: 唐 成, Email: 1520741818@163.com

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更新日期/Last Update: 2025-04-25