Clinical Analysis Of 41 Children With Acquired Benign Tracheobronchial Stenosis Treat With Comprehensive Interventional Therapy Through Bronchoscope

Objective: The aim of this retrospective study was to evaluate the efficacy and safety of comprehensive interventional therapy through bronchoscope in the treatment of acquired benign tracheobronchial stenosis in children,and to explore the factors affecting the effect.Methods: A total of 41 patients with acquired tracheobronchial stenosis treated with interventional therapy through bronchoscope from September 2014 to March 2019 were included.We retrospectively analysed the clinical data of them to evaluate the efficacy and safety.They were divided into effective group and ineffective group according to the curative effect,univariate analysis were performed to investigate the influence factors associated with efficacy.Results:(1)The total effective rate of interventional therapy through bronchoscope was 73.81%.85.71% of the patients were treated with two or more interventional methods.(2)The 23 children who measured the length of stenosis segment by CT image were divided into long segment stenosis group and short segment stenosis group.The total effective rate of short segment stenosis group was 89.47%,and that of long segment stenosis group was 25.0%.The difference between the two groups was statisticallysignificant.(3)They were divided into effective group and ineffective group according to the curative effect,there was no significant difference in sex,age,course of disease before treatment,location of lesion,number of acute lower respiratory tract infection and interventional therapy between the two groups(P > 0.05),but the ineffective group had higher proportion of scar stenosis(P=0.042).(4)A total of 213 interventional treatments were performed in 41 children,and the incidence of short-term adverse reactions was about 11.27%,but the main adverse reactions were mild adverse reactions such as slight mucosal bleeding,postoperative fever,throat discomfort and so on.Only 0.94% of the children had severe adverse reactions of dyspnea.1 case(2.44%)developed bronchial lumen collapse after repeated interventional therapy.(5)The follow-up results showed that some children may still have slight laryngitis or decreased activity tolerance at the end of interventional therapy,but the symptoms of membranous stenosis could be relieved gradually,while the symptoms of scar stenosis could not be relieved.Conclusion:Interventional therapy through bronchoscope is a relatively safe and effective treatment for children with acquired benign tracheobronchial stenosis,which is worthy of clinical promotion.It is usually necessary to choose a combination interventional methods according to the condition of the disease.Patients with scar stenosis or long segment tracheobronchial stenosis have a higher risk of ineffective bronchoscopic interventional therapy.The long-term prognosis of children with scar stenosis may be worse.In the patients with scar stenosis the therapeutic effect of who with contracted scar is worse than that of hyperplastic scar.It is very important for early regular interventional therapy for children with granulation proliferative tracheobronchial stenosis to avoid missing the opportunity of interventional therapy andaffect the therapeutic effect.