Etiological analysis of 12 cases with benign central airway stenosis and therapeutic effect of endotracheal endoscopic intervention / 中华实用儿科临床杂志

ABSTRACT

Objective:To explore the causes of 12 cases with benign central airway stenosis, and to discuss the therapeutic effect of endotracheal intubation.Methods:Children with benign central airway stenosis in the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019 were selected.Their general cli-nical data, CT airway 3D reconstruction image data and the characteristics of tracheostenosis under bronchoscope were analyzed.A variety of combined bronchoscopic interventions (high-frequency cauterization, balloon dilatation, cryotherapy) were performed.Results:The clinical data of 12 children with benign central airway stenosis were collected, including 7 males and 5 females. The main causes of benign central airway stenosis in 12 cases were tracheal stenosis after intubation (9 cases, 75.00%), tracheoesophageal fistula (1 case, 8.33%), webbed stenosis (1 case, 8.33%) after tracheotomy, and right main bronchus stenosis after foreign body entrance (1 case, 8.33%). After treatment for 4 weeks [(4.48±0.61) mm], 6 months[(5.49±0.52) mm] and 1 year[(6.13±0.26) mm ], the diameter of stenotic airways increased significantly compared with that before treatment[(1.98±0.48) mm], and the diameter of stenotic airways increased gradually with the time of follow-up ( t=12.871, 9.302, 6.737, all P<0.001); the modified British Medical Research Council scale(MMRC)score decreased significantly after treatment [4 weeks(1.17±0.94)scores, 6 months ( 0.58±0.67) scores, 1 year (0.25±0.45) scores] compared with that before treatment[(3.17±0.58) scores], and the MMRC score decreased gradually with the increase of follow-up time ( t=11.489, 3.924, 2.345, all P<0.05) . Conclusions:The most common causes of benign central airway stenosis in children are tra-cheal intubation or tracheotomy.The combination of a variety of endotracheal endoscopic interventions (high-frequency cauterization, balloon dilatation, cryotherapy) is effective in the treatment of this disease.