【科普】气管支气管镜改善气管支气管软化患者症状、生活质量、肺功能、活动能力
发布于 2008-11-16 · 浏览 2061 · IP 安徽安徽
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气管支气管镜改善气管支气管软化患者症状、生活质量、肺功能、活动能力
Tracheobronchoplasty Can Be Effective for Severe Tracheobronchomalacia
NEW YORK (Reuters Health) Nov 04 - Tracheobronchoplasty provides central airway stabilization and symptom relief in patients with severe tracheobronchomalacia (TBM), according to a report in the October issue of Chest.
"TBM is an underdiagnosed entity that can be responsible for a wide variety of pulmonary symptoms, including unexplained respiratory failure or worse than expected symptoms from emphysema," Dr. Armin Ernst from Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, told Reuters Health.
Dr. Ernst and colleagues evaluated the efficacy of surgical tracheobronchoplasty in improving symptoms, quality of life, and lung function and exercise capacity in 35 patients with severe and symptomatic TBM.
The patients had been identified as surgical candidates based on symptomatic response with temporary placement of an airway stent. The surgical procedure, following stent removal, aimed to stabilize the membranous wall of the intrathoracic trachea and mainstream bronchi.
All patients experienced improvements in the modified St. George respiratory questionnaire, the baseline dyspnea index/transitional dyspnea index, the American Thoracic Society dyspnea score, and the Karnofsky performance scale after surgery, the team reports.
Two patients who required mechanical ventilation for respiratory failure secondary to TBM were able to be weaned off ventilation after stent placement and experienced subjective and objective improvement following surgery.
Fifteen patients (43%) experienced surgical complications, including the requirement for mechanical ventilation more than 24 hours after surgery (7 patients), pneumonia/bronchitis (4), subcutaneous emphysema (4), atrial fibrillation (3), hemothorax (1), and transverse myelitis (1), and two patients (5.7%) died.
Hospital stays ranged from 3 to 90 days, with a median of 8 days, the report indicates.
"We believe that despite the limitations of our study, results are compelling and we recommend that patients with severe, diffuse, and symptomatic TBM should be evaluated in an experienced center and considered for central airway stabilization," the researchers conclude.
"Currently one should have all evaluations and interventions performed in a center experienced in the management of TBM," Dr. Ernst emphasized.
"All (our) patients are involved in a registry and are being followed on a yearly basis to better assess long term outcome," Dr. Ernst added.
Chest 2008;134:801-807.
Tracheobronchoplasty Can Be Effective for Severe Tracheobronchomalacia
NEW YORK (Reuters Health) Nov 04 - Tracheobronchoplasty provides central airway stabilization and symptom relief in patients with severe tracheobronchomalacia (TBM), according to a report in the October issue of Chest.
"TBM is an underdiagnosed entity that can be responsible for a wide variety of pulmonary symptoms, including unexplained respiratory failure or worse than expected symptoms from emphysema," Dr. Armin Ernst from Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, told Reuters Health.
Dr. Ernst and colleagues evaluated the efficacy of surgical tracheobronchoplasty in improving symptoms, quality of life, and lung function and exercise capacity in 35 patients with severe and symptomatic TBM.
The patients had been identified as surgical candidates based on symptomatic response with temporary placement of an airway stent. The surgical procedure, following stent removal, aimed to stabilize the membranous wall of the intrathoracic trachea and mainstream bronchi.
All patients experienced improvements in the modified St. George respiratory questionnaire, the baseline dyspnea index/transitional dyspnea index, the American Thoracic Society dyspnea score, and the Karnofsky performance scale after surgery, the team reports.
Two patients who required mechanical ventilation for respiratory failure secondary to TBM were able to be weaned off ventilation after stent placement and experienced subjective and objective improvement following surgery.
Fifteen patients (43%) experienced surgical complications, including the requirement for mechanical ventilation more than 24 hours after surgery (7 patients), pneumonia/bronchitis (4), subcutaneous emphysema (4), atrial fibrillation (3), hemothorax (1), and transverse myelitis (1), and two patients (5.7%) died.
Hospital stays ranged from 3 to 90 days, with a median of 8 days, the report indicates.
"We believe that despite the limitations of our study, results are compelling and we recommend that patients with severe, diffuse, and symptomatic TBM should be evaluated in an experienced center and considered for central airway stabilization," the researchers conclude.
"Currently one should have all evaluations and interventions performed in a center experienced in the management of TBM," Dr. Ernst emphasized.
"All (our) patients are involved in a registry and are being followed on a yearly basis to better assess long term outcome," Dr. Ernst added.
Chest 2008;134:801-807.
最后编辑于 2022-10-09 · 浏览 2061
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