在COVID-19之后的输管后气管狭窄症的管理和结果:一种倾向性得分匹配的研究
Arman Hasanzade1,2, Fariba Ghorbani1, Amir Ali Mahboobipour1
1Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Interdisciplinary cardiovascular and thoracic surgery
|February 2, 2026
概括
与COVID-19相关的输液后气管狭窄症 (PITS) 患者需要比非COVID-19 PITS患者更多的气道切除. 胸部外科医生应该考虑更早地对COVID-19 PITS进行手术干预,以改善结果.
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:
- 输入管后气管狭窄症 (PITS) 的患病率有所增加,原因是与COVID-19相关的输入管率增加.
- 将COVID-19幸存者的PITS与其他病因进行比较对于了解疾病特征和管理至关重要.
研究的目的:
- 为了比较COVID-19相关的 (CR) 与非COVID-19相关的 (NCR) 病因病理的患者的输液管后狭窄 (PITS).
- 评估CR-PITS和NCR-PITS之间的临床表现,狭窄特征,治疗和结果的差异.
主要方法:
- 从2018年1月到2023年5月,对337名PITS患者进行了前性队列研究.
- 排除直接部创伤,吸入伤害或之前进行过气管外科手术的患者.
- 倾向性得分匹配 (PSM) 用于比较59名CR-PITS患者与59名NCR-PITS患者.
主要成果:
- 在匹配之前,CR-PITS患者与NCR-PITS患者相比,输管持续时间更长,糖尿病发病率更高.
- 在PSM之后,CR-PITS患者需要显著更多的气道切除 (81.4%) 进行最终管理,而不是NCR-PITS患者 (42.4%).
- 在PSM后的两组之间,在狭窄特征,术后并发症,复发或整体结果方面没有发现显著差异.
结论:
- 与COVID-19相关的PITS与非COVID-19 PITS相比,需要更高的手术切除率.
- 胸部外科医生应考虑在CR-PITS患者的早期切除气道手术,因为保守治疗失败的可能性更高.
- 在CR-PITS患者中,迅速的外科干预可能会导致与NCR-PITS患者相似的术后结果.
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