| Objective:In recent years,the incidence of respiratory diseases is increasing year by year in china,and the incidence of benign central airway stenosis was also increased.The pathogeny of benign airway stenosis is complex,Because of the recurrence of tuberculosis,the main cause of benign airway stenosis in our country is pulmonary tuberculosis.And other reasons,such as tracheal intubation,tracheotomy,And that some of the rare causes,such as Tracheobron-cheopathia osteoplastica(TOP)and bronchial amyloidosis,are also the causes of benign airway stenosis.Benign airway stenosis symptoms can be varied.It can seriously affect the quality of life of patients,and benign central airway stenosis has a long survival time,bring heavy burden to patients and their families.For the treatment of benign central airway stenosis before,the main treatment methods were surgical resection,which include end to end anastomosis and reconstruction of the operation.But the operation technique is so difficult that caused surgical injury and postoperative complications,so it has less adopted clinically.In recent years,the development of medical intervention in the treatment of benign central airway stenosis has the advantages of small trauma,and can adapt to the elderly patients with poor heart and lung foundation.Medical intervention can relieve the symptoms of the patients,but benign airway stenosis and repeated trauma scar formation,easily complicated with restenosis.Therefore,we need a new treatment plan to reduce airway restenosis.Budesonide is a synthetic glucocorticoid with potent anti-inflammatory potency,It combines second messengers on the cell membrane,into the nucleus,affecting the expression of DNA,It can reduce the expression of TGF-β1,inhibit the proliferation of fibroblasts,to reduce the formation of collagen fibers,to reduce granulation tissue hyperplasia and scar formation.Many clinical Studies used budesonide in the treatment of airway stenosis,the budesonide can inhibit the formation of scar tissue and airway restenosis.The respiratory interventional technology is still evolving,to treat benign central airway stenosis by combined hormonal intervention,it can improve the incidence of restenosis,and it has great significance to reduce the burden of society and patients.In this study,we adopt the way of budesonide combined with temporary stent implantation,to treat benign central airway stenosis,to compare with simple stent interventional therapy,and Assess the value of clinical efficacy,adverse reactions and the incidence of airway restenosis.In order to improve the comprehensive treatment of benign central airway stenosis.Methods:42 patients with severe benign central airway stenosis in the second affiliated hospital of Nanchang University;Xiamen respiratory disease hospital from March 2014 to March 2016.And check up complete blood count,liver tests,renal function,coagulation function,blood gas analysis,ECG and lung-function testing before Intervention.According to cardiopulmonary function and the severity of airway stenosis,we can determine the appropriate mode of intervention.The experimental group and the control group would be treated with conventional stent placement.The treatment group was given budesonide suspension after routine stent insertion,2 times a day for 2 weeks.The stent both in the experimental group and the control group would be removed.To evaluate the diameter of stenosis before treatment,1 months and 6 months after treatment.Result:The average airway diameter of budesonide group per-treatment(0.345±0.0182)cm,after 1 month of treatment was(0.702±0.0215)cm,the recent improvement of airway diameter was(0.341±0.0146)cm,after 6 month was(0.695±0.0231)cm,the long-term improvement of airway diameter was(0.336±0.0164)cm;The average airway diameter of budesonide group per-treatment(0.312±0.0167)cm,after 1 month of treatment was(0.697±0.0228)cm,the recent improvement of airway diameter was(0.327±0.0178)cm,after 6 month was(0.449±0.0266)cm,the long-term improvement of airway diameter was(0.141±0.0255)cm;Obviously the average airway diameter of both in the control group and the budesonide group were Significantly increased.But the budesonide group compared to the control group,the average airway diameter increased more advantageous after 6 month of treatment,the difference was statistically significant.Conclusions:topical inhalation of budesonide therapy combined with traditional interventional technique has good curative effect.It can reduce recurrence of airway stenosis and extension of time to be treated again.It provides a new way for comprehensive treatment of benign airway stenosis. |
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