目的 观察激光在器质性呼吸道阻塞性疾病治疗中的应用价值。方法 应用Nd：YAG激光治疗40例器质性呼吸道阻塞患者，观察治疗前后患者症状、肺功能、血气分析、气道内径的改善情况及治疗的安全性。结果 应用Nd：YAG激光治疗后患者气道全部通畅，气道内径明显扩大：治疗前(2.9±1.7)mm，治疗后(8.0±1.6)mm，P＜0.01；气促明显缓解：气促指数治疗前3.2±0.8，治疗后1.3±0.9，P＜0.01；PaO2明显升高：治疗前(9.4±1.81)kPa，治疗后(11.6±1.1)kPa，P＜0.01；FEV１明显改善：治疗前(1.4±0.3)L，治疗后(2.4±0.4)L，P＜0.01；FVC明显增加：治疗前(2.3±0.7)L，治疗后(3.3±0.6)L，P＜0.01；治疗过程中32例出现一过性低氧血症，2例出血，5例术后呼吸困难，2例术后发热。术后随访：17例患者术后3～4个月出现气道再次狭窄，11例经再次激光治疗后气道再次通畅。结论 Nd：YAG激光治疗器质性呼吸道阻塞是安全有效的手段并可反复应用，值得临床推广使用。%Objective To study the efficacy of laser in the treatment of airway stenosis.Methods 40 cases with airway stenosis were treated by Nd:YAG laser from June 1998 to September 2000. Dyspnea index, airway diameter, pulmonary function and complications were observed.Results All airways were restructured following a single or multiple laser treatments. Dyspnea index was immediately improved from 3.2±0.8 to 1.3±0.9(P＜0.01)， airway diameter from 2.9±1.7 mm to 8.0±1.6 mm(P＜0.01), PaO2 from 9.6±1.4 kPa to 11.6±1.1(P＜0.01)， FEV１ from 1.4±0.3 to 2.4±0.4(P＜0.01), and FVC from 2.3±0.7 to 3.3±0.6(P＜0.01)， respectively. Complications included thirty-two hypoxemia, two hemorrhage, five postoperative dyspnea and two fever. Follow-up information showed that the stenoses recurred in 17 case 3～4 month postoperation, and 11 cases were retreated successfully with a second laser treatment.Conclusion Nd：YAG laser treatment is effective and safe in the treatment of patients with occluded airways and can be repeated.
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