在冠状病毒疾病-19时代的气管狭窄和呼吸道并发症
Aravind Krishnan1, Brandon A Guenthart1, Ashley Choi1
1Department of Cardiothoracic Surgery, Stanford University, Stanford, CA.
Annals of thoracic surgery short reports
|June 26, 2023
概括
严重的COVID-19引起的输管后气管狭窄是一个越来越令人担忧的问题. 手术管理,包括气管切除和重建,为患有这种并发症的患者提供有效的治疗和良好的结果.
科学领域:
- 肺部病理学 肺部病理学
- 胸部外科手术 胸部外科手术
- 传染性疾病 传染性疾病
背景情况:
- 2019年严重的冠状病毒病 (COVID-19) 需要长时间的输管治疗,增加并发症的风险.
- 气管狭窄是一种显著的输管后并发症,需要专门的手术干预.
- 随着患者生存率的提高,COVID-19后气管狭窄的发生率可能会增加.
研究的目的:
- 描述严重COVID-19感染后开发的气管管狭窄的外科治疗策略.
- 评估COVID-19后气管狭窄症的不同手术干预措施的安全性和有效性.
主要方法:
- 研究人员对8名患有COVID-19输管术后气管管狭窄症的患者进行了一系列病例.
- 患者接受了气管切除和重建 (TRR) 或非切除的支气管镜干预.
- 评估的结果包括无症状生存率和组织病理学发现.
主要成果:
- 在5名患者中进行了气管切除和重建 (TRR),达到80%的六个月无症状生存率.
- 不基于切除的治疗,包括气球扩张和激光切除,在三分之二的患者中提供了持久的缓解.
- 系列中的所有患者都是女性,肥胖患病率很高 (87.5%).
结论:
- 气管切除和重建 (TRR) 是COVID-19后气管狭窄症的安全有效治疗方法,成功率与非COVID-19病例相似.
- 基于非切除的管理对于不太严重的狭窄症患者或不适合进行重大手术的患者来说是一个可行的替代方案.
- 对于COVID-19后的气管狭窄症,需要提高警和管理策略.
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