Effect of bronchoscopic balloon dilation with different intervals in treatment of children with subglottic stenosis caused by tracheal intubation
- VernacularTitle:支气管镜下球囊扩张治疗不同间期对儿童气管插管致声门下狭窄的疗效观察
- Author:
Lidan CUI
1
;
Liujiong GAO
;
Conghui LI
;
Jun SU
;
Zhipeng JIN
;
Zheng LI
Author Information
- Keywords: tracheal intubation; subglottic stenosis; balloon dilation; children; interval time
- From: Journal of Clinical Medicine in Practice 2024;28(14):82-86
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the effect of bronchoscopic balloon dilation treatment of dif-ferent intervals on the tracheal intubation-induced subglottic stenosis in children.Methods Children with tracheal intubation-induced subglottic cicatricial stenosis were selected as the research objects.Among the 36 children with pure balloon dilation treatment,20 cases were enrolled in the observation group and 16 cases were enrolled in the control group.In the observation group,electronic bronchos-copy was performed at 3 days after the first-time balloon dilation treatment,and those with grade 2 or higher stenosis received the second-time balloon dilation treatment.The follow-up treatment principle was as follows.If there was obvious retraction compared with the previous time and the stenosis was grade 2 or higher,the balloon dilation treatment would be performed again after an interval of 3 days;if there was no obvious retraction,the evaluation would be performed again after an interval of 2 weeks until there was no obvious retraction in the stenosis site under endoscopy for 3 times in 6 consecutive weeks,and the degree of stenosis was less than 25％,and then the electronic bronchoscopy evaluation would be stopped.In the control group,electronic bronchoscopy was performed 7 days after the first-time balloon dilation treatment,and those with grade 2 or higher stenosis received the second-time balloon dilation treatment.The follow-up treatment principle was as follows.If there was obvious re-traction compared with the previous time and the stenosis was grade 2 or higher,the balloon dilation treatment would be performed again after an interval of 7 days;the evaluation method for those with-out obvious retraction was the same as the observation group.The follow-up duration ranged from 6 to 9 months.Results There was no significant difference in the total number of treatments and out-comes between the two groups(P＞0.05).The treatment duration of the observation group was sig-nificantly shorter than that of the control group(P＜0.05).There were no significant differences in intraoperative complications such as bleeding,oxygen saturation decrease,heart rate decrease,and blood pressure decrease during anesthesia between the two groups(P＞0.05).There were no sig-nificant differences in postoperative fever,aggravated laryngeal stridor,and dyspnea between the two groups(P＞0.05).There were no significant differences in dyspnea,activity tolerance,and the need for long-term oxygen therapy between the two groups(P＞0.05).Conclusion Most of the tracheal intubation-induced subglottic cicatricial stenosis in children has a good medium-and long-term effect through pure balloon dilation treatment.Shortening the interval of pure balloon dilation to 3 days can shorten the total treatment duration,alleviate the psychological burden of parents,but does not increase their economic burden.There are no significant differences in intraoperative and postoperative complications,outcomes,and long-term follow-up compared with the original interval of 5 to 7 days.
