The Treatment Effect Observation And Treatment Method Analysis Of 74 Patients With Laryngotracheal Stenosis

Objective:This paper retrospectively analyzed the methods and effects of admission treatment for patients with laryngotracheal stenosis,and discussed the more effective treatment methods for laryngotracheal stenosis,and provided certain guidance for clinical treatment.Methods:By collecting clinical data of patients with laryngotracheal stenosis treated before January 2018 in the first affiliated hospital of Kunming Medical University,the second affiliated hospital of Kunming Medical University,Kunming general hospital of the people’s liberation army and Yunnan cancer hospital,Including the patient’s general information(age,gender,contact information,hospital number,length of hospital stay,diagnosis,the chief complaint,history),the cause of narrow,the region and the degree of stenosis(combined with endoscopic examination,CT or MRI),preoperative situation(with or without dyspnea,pronunciation,swallowing),treatment,postoperative conditions(tube drawing,survival rate,restenosis,breathing,pronunciation,swallowing),analyze the relationship between the factors and the therapeutic effect.Results:There are 74 out of 82 cases of laryngotracheal stenosis were enrolled,and the rest 6 were abandoned or untreated,2 were transferred to other hospital.The 74 people in the group were between the ages of 8 and 73,among which 59 were male;15 were female.The causes of stenosis were:9 cases of trauma,accounting for 12.16%(9/74);6 cases were infected,accounting for 8.11%(6/74);14 cases of tumor,accounting for 18.92%(14/74);42 cases of endotracheal intubation or tracheotomy,accounting for 56.76%(42/74);There are still 3 persons caused by unknown reason,accounting for 4.05%(3/74).The 74 people in the group were divided according to myer-cotton standard(1994),and the stenosis was distributed as:4 cases of grade 1 of stenosis,accounting for 5.41%(4/74);32 cases of grade 2,accounting for 43.24%(32/74);26 cases of grade 3,accounting for 35.14%(26/74);12 cases of grade 4,accounting for 16.22%(12/74).According to the position of laryngotracheal stenosis:2 cases of laryngotracheal stenosis in the glottis and the upper region of the glottis,9 cases in the glottis and subglottic area,13 cases of glottal area,50 cases in subglottic area.Among them,63 cases of simple site stenosis,accounting for 85.14%(63/74),;and the rest was 11 cases accounting for 14.86%(11/74).Clinical manifestations:among the 74 patients in the group,there were 73 patients with dyspnea,accounting for 98.65%(73/74).21 people with abnormal pronunciation,accounting for 28.38%(21/74);There were 15 abnormal swallowing functions,accounting for 20.27%(15/74).And there are 49 patients treated once,25 cases that are treated more than once,and 3 cases of death.The average length of hospitalization for 74 people who received treatment was16.13 days.There were 29 people out of the tube,and 29 undrawn tubes when out of the hospital.And then,the extraction rate is 50%(29/58).Furthermore,there were 21 patients with abnormal pronunciation before treatment and no significant improvement after treatment.Besides there were 15 patients with dysphagia before treatment,and 6 with dysphagia after the treatment.So the improvement in swallowing was 60%(9/15)after treatment..Conclusion:Nowadays,there are more patients with laryngotracheal stenosis caused by trauma,tracheal intubation and tracheotomy,and the number of patients with benign and malignant tumors increases year by year.In clinical treatment,different treatment options should be selected according to the specific etiology,narrow site,narrow extent,narrow length and specific clinical manifestations of patients.And it is necessary to choose the specific treatment plan for the therapeutic effect of laryngotracheal stenosis in clinic according to the patient’s different conditions.Generally speaking,for patients with mild laryngotracheal stenosis,ndoscopic surgery is an option.And for patients with moderately severe laryngotracheal stenosis,open surgery should be chosen.Besides,endoscopic surgery has a better therapeutic effect than open surgery.In the meantime,continue to explore and research new medications and new treatments for laryngotracheal stenosis to give more treatment options and better therapeutic effect to patients with laryngotracheal stenosis,and to Improve the patient’s survival rate and quality of life.