目的

分析支气管镜下钬激光治疗中心气道狭窄（central airway obstruction，CAO）患者的临床疗效及安全性，探讨该技术治疗不同病因致狭窄的作用，为临床提供参考。

方法

选择2017 年12 月至2023 年8 月我院收治的7 例因不同病因致中心气道狭窄患者。 患者接受支气管镜下钬激光治疗。分析治疗过程中的安全性、疗效及钬激光在治疗中的作用。

结果

7 例中心气管狭窄患者中女2 例，男5 例，年龄57～69 岁，平均年龄（65.43±6.32）岁。 良性中心气道狭窄4 例，恶性狭窄3 例。 狭窄部位分布于主气管2 例，主支气管或中间支气管5 例。 原发病因包括错构瘤1 例、气管切开术后狭窄1 例、支气管异物1 例、支气管结石1 例及肺癌致中心气道狭窄3 例。 患者经支气管镜下钬激光治疗，治疗过程中少量出血，未发生气胸或感染等并发症。 治疗后胸闷气促、咳嗽、咳痰等症状减轻或消失。

结论

支气管镜下钬激光治疗多种病因致中心气道狭窄较其他治疗技术具有去除病变速度快和术野清晰等优势，有利于消融骨性异物及破坏移位支架等，治疗过程安全性好，适用于良性和恶性病变治疗。

Objective

To analyze the efficacy and safety of bronchoscopic holmium laser in the treatment of central airway obstruction （CAO） while investigating its distinctive role in obstruction caused by various diseases，thus providing valuable insights for clinicians when applying this technique.

Methods

All of 7 patients with central airway obstruction caused by various etiologies selected from Zhuzhou Second Hospital between December 2017 and August 2023. These patients were all treated with bronchoscopic holmium laser therapy，and it was analyzed these cases carefully to evaluate the safety and efficacy of this treatment method in central airway obstruction.

Results

The patients consisted of 2 females and 5 males，Age 57 ～69 years old，with an average age of （65.43±6.32）years. Based on etiology，benign central airway obstruction was observed in 4 patients，while malignant central airway obstruction was present in 3 patients. Obstruction lesions involved the trachea 2 cases as well as the main or intermediate bronchus 5 cases. The primary etiologies encompassed a diverse range including hamartoma 1 case，post-tracheotomy stenosis 1 case，bronchial foreign body 1 case，bronchial calculus 1 case，and central airway obstruction due to lung cancer 3 cases. The patient was treated with holmium laser under bronchoscopy. There was a small amount of bleeding during the treatment，and no complications such as pneumothorax or infection occurred. After treatment，the symptoms such as chest tightness，shortness of breath，cough and expectoration were alleviated or disappeared.

Conclusion

Bronchoscopic holmium laser therapy has several advantages in the treatment of central airway obstruction such as rapid removal of lesions and clear surgical field，in particular，it plays an irreplaceable role in ablating bony foreign bodies and destroying dislocated stent，and it is safe in the treatment process. Notably，this technology is suitable for treating both benign and malignant lesions，holding significant value as a therapy option.