分析经支气管镜超脉冲掺钕钇铝石榴石(nodymium-added yttrium aluminum garnet, Nd︰YAG)激光(型号：Ligenesis-MY100C)消融治疗中心气道狭窄的安全性和有效性。

收集2022年1月至2024年9月我院呼吸与危重症医学科进行经支气管镜超脉冲Nd︰YAG激光消融治疗的45例患者，分析临床资料、激光治疗情况及预后。

45例中心气道狭窄患者中，恶性气道狭窄32例(74.42%)，其中肺鳞癌21例(65.62%)，肺腺癌7例(21.88%)，小细胞肺癌3例(9.38%)，腺样囊性癌1例(3.12%)，显示在鳞癌、腺癌导致中心气道狭窄的发生率接近；良性气道狭窄13例(25.58%)，其中气管内膜结核7例(53.85%)，错构瘤5例(38.46%)、气管骨化病1例(7.69%)。经支气管镜超脉冲Nd︰YAG激光消融治疗，术中未发现灼伤、中-大量出血、麻醉不可控制的心律失常，术后未发生窒息、心律失常、频繁咳嗽、疼痛。术后3个月，良性气道狭窄的患者气道未再出现狭窄，10例恶性气道狭窄患者由于肿瘤的再生长，再次出现气道狭窄。操作过程中需要断氧，消融产生的烟雾可以由持续负压吸引而清理气道以获得清晰视野。患者经激光消融治疗后KPS评分术后明显改善，差异有统计学意义(P<0.05)。

经支气管镜超脉冲Nd︰YAG激光消融可安全广泛用于各种良恶性中心气道狭窄，良性气道狭窄获益较多；对于恶性气道狭窄患者需结合有效全身治疗控制原发病灶。

To analyze the safety and efficacy of transbronchoscopic superpulse Nd: YAG laser (model: Ligenesis-MY100C) ablation in the treatment of central airway stenosis.

From January 2022 to September 2024, transbronchoscopic hyperpulse Nd︰YAG laser was performed by the Department of Respiratory and Critical Care Medicine of our hospital. Clinical data of 45 patients treated with Ligenesis-MY100C were analyzed, including general clinical data, laser treatment and post-treatment follow-up.

Among the 45 patients with central airway stenosis, 32 cases (74.42%) were pulmonary malignant tumors, including 21 cases (65.62%) of lung squamous cell carcinoma, 7 cases (21.88%) of lung adenocarcinoma, 3 cases (9.38%) of small cell lung cancer, and 1 case of adenoid cystic carcinoma (3.12%), indicating that the rates of central airway stenosis caused by squamous cell carcinoma and adenocarcinoma were similar. There were 13 cases of benign lung lesions (25.58%), including 7 cases of endotracheal tuberculosis (53.85%), 5 cases of hamartoma (38.46%) and 1 case of tracheal ossification (7.69%). After bronchoscopic superpulse Nd︰YAG laser ablation, no burns, moderate to massive bleeding, or uncontrollable arrhythmia were found during the operation. No asphyxia, arrhythmia, frequent cough, or pain occurred after the operation. After 3 months of follow-up, no patients with benign airway stenosis had airway stenosis again, and about 10 patients with malignant airway stenosis had airway stenosis again due to tumor regrowth. Oxygen is cut off during the operation, and the smoke produced by ablation can be drawn by continuous negative pressure to clear the airway for a clear view. The KPS score of the patients after laser ablation was significantly improved, and the difference was statistically significant (P<0.05).

Transbronchoscopic superpulse Nd︰YAG laser ablation can be safely and widely used for benign and malignant central airway stenosis as long as the operation skills are mastered, and benign airway stenosis has more benefits. For patients with malignant airway stenosis, the primary lesion should be controlled with effective systemic therapy.