昆明医科大学学报2026，Vol.47Issue(1)：79-89,11.DOI:10.12259/j.issn.2095-610X.S20260110
多模式呼吸介入方法联合治疗良性中央气道狭窄的疗效及预后因素分析
Efficacy of Multimodal Bronchoscopic Interventions for Benign Central Airway Stenosis and Prognostic Factors:A Retrospective Cohort Study
摘要
Abstract
Objective To compare the clinical efficacy of three bronchoscopic interventional regimens for benign central airway stenosis(BCAS)and identify prognostic factors,so as to provide evidence-based support for i ndividualized treatment.Methods A total of 101 BCAS patients who underwent bronchoscopic interventional therapy at the Respiratory Endoscopy Center of The First Affiliated Hospital of Kunming Medical University from January 2022 to December 2024 were retrospectively enrolled.They were divided into three groups according to the treatment regimen:Group A(Nd:YAG laser+balloon dilation,n=31),Group B(Nd:YAG laser+balloon dilation+triamcinolone acetonide,n=33),and Group C(Nd:YAG laser+balloon dilation+triamcinolone acetonide+cryotherapy,n=37).The primary endpoints included treatment effective rate,restenosis-related indicators(incidence and median time),quality of life,and complication rate.Statistical analyses were performed using SPSS 26.0 and GraphPad Prism 9.0.Results At 2 months after surgery,the stenosis grade in Group C(3.05±0.70)was significantly superior to that in Groups A and B(P=0.002),with a more obvious decrease in white blood cell count.During the 12-month follow-up,the total effective rate of Group C reached 86.49%,which was significantly higher than that of Group A(67.74%)and Group B(69.70%)(P<0.05).The median time to first restenosis in Group C(4.7 months)was 47.5%longer than that in Group A(3.2 months)and Group B(3.5 months)(P=0.020).Both the improvement rate of forced expiratory volume in 1 second(FEV1)(27.8%)and the Karnofsky score at the last follow-up(82.7 points)in Group C were significantly higher than those in the other two groups(P<0.01).In terms of safety,there was no significant difference in the incidence of bleeding among the three groups,but the incidence of hypoxemia in Group B was relatively higher(21.2%).Subgroup analysis showed that the treatment effective rate of Group C in patients with post-intubation stenosis(90.00%)was significantly higher than that in Group A(63.64%)and Group B(72.73%)(P=0.045),while the advantage in patients with tuberculous stenosis did not reach statistical significance(P=0.089).Multivariate Logistic regression analysis revealed that the treatment regimen was an independent prognostic factor for BCAS patients(OR=3.258,95%CI:1.563-6.794,P=0.002).Conclusion The quadrature therapy regimen integrating Nd:YAG laser ablation,balloon dilation,intralesional triamcinolone acetonide injection,and cryotherapy demonstrates superior clinical efficacy in the management of benign central airway stenosis(BCAS).This multimodal approach significantly enhances the therapeutic response rate and markedly prolongs the restenosis-free interval.关键词
良性中央气道狭窄/介入呼吸病学/多模式治疗/再狭窄/预后因素/回顾性研究Key words
Benign central airway stenosis/Interventional pulmonology/Multimodal therapy/Restenosis/Prognostic factors/Retrospective study分类
医药卫生引用本文复制引用
李城锦,伍蓉蓉,刘桂苹,唐杰夫,王乐,罗壮..多模式呼吸介入方法联合治疗良性中央气道狭窄的疗效及预后因素分析[J].昆明医科大学学报,2026,47(1):79-89,11.基金项目
云南省科技厅-昆医联合专项项目(202301AY070001-090) （202301AY070001-090）
云南省科技厅联合专项项目(202201AY070001-055) （202201AY070001-055）
昆医大学附一院2022年第一批高层次人才535人才计划"学科带头人"(2022535D01). （2022535D01）
