全降解药物支架治疗先天性后鼻孔闭锁的疗效观察

Effect of drug-eluting stent in the treatment of congenital choanal atresia

摘要:

目的 探讨全降解药物支架治疗先天性后鼻孔闭锁（CCA）的效果及对预后的影响。方法 回顾性分析2016年1月—2019年12月收治的14例CCA患儿，使用低温等离子射频消融术切除闭锁板的膜性部分，骨凿去除闭锁板的骨性部分。按术中放置支架类型不同分为全降解药物支架组6例，U型支架组8例。对比分析采用不同支架组患儿术后并发症的发生率。结果 两组患儿术后均定期专科门诊随访6个月以上，药物支架组术后未发生鼻腔粘连，肉芽增生10%（1/10）；U型支架组术后鼻腔粘连率为44.44%（4/9），肉芽增生率为55.56%（5/9），两组间差异具有统计学意义（P<0.05）。药物支架组后鼻孔再闭锁率为10%（1/10），低于U型支架组后鼻孔再闭锁率33.33%（3/9），但两组间差异无统计学意义（P>0.05）。结论 全降解药物支架可作为治疗CCA的新型支架。

关键词:鼻部畸形;后鼻孔闭锁;先天性;儿童;药物支架

Abstract:

Objective To observe the effect of drug-eluting stent in the treatment of congenital choanal atresia (CCA). Methods A retrospective study was performed in 14 patients with CCA hospitalized in Kunming Children's Hospital from Jan 2016 to Dec 2019. Low-temperature plasma radiofrequency ablation was used to remove the membranous part of the atresia plate, and an osteotome was used to remove the bony part. After removal of the atresia plate, drug-eluting stent was placed in 6 patients and U-tape stent in 8. The incidence of postoperative complications was compared between the two groups. Results All the cases had been followed up more than 6 months postoperatively. No postoperative nasal adhesion occurred in the drug-eluting stent group with a granulation proliferation rate of 10%. The rates of postoperative nasal adhesion and granulation proliferation were 44.4% and 55.6% in the U-tape stent group. The differences between the two groups were statistically significant (both P<0.05). The rate of nostril reocclusion in the drug-eluting stent group (10%) was lower than that of the U-tape stent group (33.3%), but the difference was statistically insignificant (P>0.05). Conclusion The drug-eluting stent can be used as a novel type of stent in the treatment of CCA.

Key words:Nasal deformity;Choanal atresia;Congenital;Child;Drug-eluting stent