经支气管镜局部注射自体富血小板血浆治疗气管支气管瘘的效果

doi:10.3760/cma.j.cn441417-20250213-19014

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (19): 3236-3240.DOI: 10.3760/cma.j.cn441417-20250213-19014

经支气管镜局部注射自体富血小板血浆治疗气管支气管瘘的效果

区思毅吴尚君罗东玲陈雪平

钦州市第一人民医院呼吸与危重症医学科，钦州 535000

收稿日期:2025-02-13 出版日期:2025-10-01 发布日期:2025-10-24
通讯作者: 区思毅，Email：602346437@qq.com
基金资助:
广西壮族自治区卫生健康委员会自筹经费科研课题（Z-N20221879）

The effect of local injection of autologous platelet rich plasma via bronchoscopy in the treatment of tracheobronchial fistula

Ou Siyi, Wu Shangjun, Luo Dongling, Chen Xueping

Department of Respiratory and Critical Care Medicine, The First People's Hospital of Qinzhou, Qinzhou 535000, China

Received:2025-02-13 Online:2025-10-01 Published:2025-10-24
Contact: Ou Siyi, Email: 602346437@qq.com
Supported by:
Self-funded Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region (Z-N20221879)

摘要/Abstract

摘要：

目的　探讨经支气管镜局部注射自体富血小板血浆治疗气管支气管瘘的效果。方法　选取2023年1月至2025年1月钦州市第一人民医院收治的30例气管支气管瘘患者作为研究对象。按治疗方法不同，将患者分为对照组（20例）和研究组（10例）。对照组男15例，女5例；年龄20～70（50.92±8.01）岁，瘘口直径1.20～5.00（4.10±0.50）mm。研究组男8例，女2例；年龄20～70（50.85±8.96）岁，瘘口直径1.10～4.90（4.05±0.45）mm。对照组采用内科抗感染、营养支持等保守治疗，研究组采用经支气管镜局部注射自体富血小板血浆治疗。两组均连续治疗3周。比较两组瘘口愈合情况，治疗前后气促评分和卡氏功能状态评分量表（KPS）评分。采用独立样本t检验和Fisher确切概率法进行统计学分析。结果　对照组20例气管支气管瘘患者（共22个瘘口），完全愈合率为54.55%（12/22），不完全愈合率为45.45%（10/22）。研究组10例气管支气管瘘患者（共10个瘘口），完全愈合率为90.00%（9/10），不完全愈合率为10.00%（1/10）。两组比较，差异有统计学意义（P<0.05）。治疗后，研究组气促评分低于对照组，KPS评分高于对照组［（1.60±0.40）分比（2.10±0.10）分、（85.10±10.20）分比（75.30±8.00）分］（均P<0.05）。结论　经支气管镜局部注射自体富血小板血浆治疗气管支气管瘘的效果较好，可提高患者生活质量。

关键词:

气管支气管瘘, 自体富血小板血浆, 支气管镜, 局部注射

Abstract:

Objective　To explore the efficacy of local injection of autologous platelet rich plasma via bronchoscopy in the treatment of tracheobronchial fistula. Methods　Thirty patients with tracheobronchial fistula who were admitted to the First People's Hospital of Qinzhou from January 2023 to January 2025 were selected as the study subjects. According to the different treatment methods, the patients were divided into the control group (20 cases) and the study group (10 cases). There were 15 males and 5 females in the control group, aged 20-70 (50.92±8.01) years, diameter of the fistula opening 1.20-5.00 (4.10±0.50) mm. There were 8 males and 2 females in the study group, aged 20-70 (50.85±8.96) years, diameter of the fistula opening 1.10-4.90 (4.05±0.45) mm. The control group received conservative treatments such as anti-infection and nutritional support, while the study group was treated with local injection of autologous platelet rich plasma via bronchoscopy. Both groups were treated continuously for 3 weeks. The healing conditions of the fistulas were compared between the two groups, and measure the dyspnea score and the Karnofsky Performance Status Scale (KPS) score before and after treatment. Independent sample t test, and Fisher's exact probability method were used for statistical analysis. Results　Among the 20 patients with tracheobronchial fistulas in the control group (with a total of 22 fistula openings), the complete healing rate was 54.55% (12/22), and the incomplete healing rate was 45.45% (10/22). Among the 10 patients with tracheobronchial fistulas in the study group (with a total of 10 fistula openings), the complete healing rate was 90.00% (9/10), and the incomplete healing rate was 10.00% (1/10). There was a statistically significant difference between the two groups (P<0.05). After treatment, the dyspnea score of the study group was lower than that of the control group, and the KPS score was higher than that of the control group [(1.60±0.40) points vs. (2.10±0.10) points, (85.10±10.20) points vs. (75.30±8.00) points] (both P<0.05). Conclusion　Local injection of autologous platelet rich plasma via bronchoscopy has a better therapeutic effect on tracheobronchial fistula and can improve the quality of life of patients.

Key words:

Tracheobronchial fistula, Autologous platelet rich plasma, Bronchoscopy, Local injection

区思毅吴尚君罗东玲陈雪平.

经支气管镜局部注射自体富血小板血浆治疗气管支气管瘘的效果 [J]. 国际医药卫生导报, 2025, 31(19): 3236-3240.

Ou Siyi, Wu Shangjun, Luo Dongling, Chen Xueping.

The effect of local injection of autologous platelet rich plasma via bronchoscopy in the treatment of tracheobronchial fistula [J]. International Medicine and Health Guidance News, 2025, 31(19): 3236-3240.

参考文献

[1] 谢炳灿,李臻,李鑫,等.介入治疗胆管支气管瘘疗效探讨(附3例分析)[J].临床放射学杂志,2022,41(4):761-763.DOI:10.13437/j.cnki.jcr.2022.04.020.
[2] 尹桂东,孙雯雯,周逸鸣,等.多学科模式行外科微创手术成功治疗高龄结核性脓胸并发胸膜支气管瘘一例[J].中国防痨杂志,2023,45(8):819-822.DOI:10.19982/j.issn.1000-6621.20230123.
[3] 赵壁,黄锐晨,王琴,等. 选择性支气管封堵术治疗胆管支气管瘘的疗效分析[J]. 中华医学杂志,2022,102(44):3505-3509.
[4] 何蓉会,肖巧,肖雨,等. 食管癌支架植入术后食管-支气管瘘继发多重病原菌血流感染1例[J]. 中华传染病杂志,2022,40(7):425-427. DOI:10.3760/cma.j.cn311365-20220125-00024.
[5] 富文达,李娜,魏华,等.自体富血小板血浆联合负压封闭引流技术治疗慢性难愈性创面疗效的Meta分析[J].中国输血杂志,2023,36(2):155-160.DOI:10.13303/j.cjbt.issn.1004-549x.2023.02.015.
[6] Lee JY, Son SJ, Choi SH, et al. The healing effect of platelet-rich plasma (PRP) jelly in rabbits undergoing tracheal resection and anastomosis[J]. In Vivo, 2019, 33(1):75-78. DOI: 10.21873/invivo.11441.
[7] 陈浩,侯孝涛,陈艳妮,等.瘘管剔除内口外移术联合富血小板血浆凝胶填充对肛瘘的临床疗效观察[J].现代医学,2023,51(8):1104-1108.DOI:10.3969/j.issn.1671-7562.2023.08.013.
[8] 邢亚恒,康晓燕,李景钊. 经纤维支气管镜微波治疗对中心气道狭窄患者肺功能及生活质量的影响[J]. 新乡医学院学报,2020,37(2):170-172,176. DOI:10.7683/xxyxyxb.2020.02.016.
[9] 刘娟,刘洋,刘小华,等.预后营养指数及其他临床指标与脑胶质瘤术后患者预后的相关性分析[J].实用临床医药杂志,2023,27(8):118-122,125.DOI:10.7619/jcmp.20230487.
[10] 段纪成,徐静,吴申,等. 肝癌切除术后胆管气管瘘的处理(附6例报道)[J]. 肝胆外科杂志,2023,31(3):218-220. DOI:10.3969/j.issn.1006-4761.2023.03.016.
[11] 谭建龙,陈风雨,欧阳彬,等. 经支气管镜置入房间隔缺损封堵器治疗中心型气道胸膜瘘的临床疗效评价[J]. 中国呼吸与危重监护杂志,2023,22(6):403-407. DOI:10.7507/1671-6205.202204024.
[12] 何志勇,陈军,石卫星,等. 自体富血小板血浆凝胶技术在网状植皮治疗大面积皮肤缺损创面中的临床研究[J]. 临床外科杂志,2023,31(3):294-297. DOI:10.3969/j.issn.1005-6483.2023.03.028.
[13] Han J, Yue L, Jia W, et al. Local injection of platelet-rich plasma offers a new therapeutic option for the treatment of esophagotracheal fistula: a case report[J]. J Int Med Res, 2024, 52(1):3000605231220874. DOI: 10.1177/03000605231220874.
[14] Siddique A, Sabbah BN, Arabi T, et al.Treatment of bronchial anastomotic fistula using autologous platelet-rich plasma post lung transplantation[J]. J Cardiothorac Surg, 2022, 24, 17(1):204. DOI: 10.1186/s13019-022-01965-w.
[15] Di Mitri M, Chiastra G, Collautti E, et al. Platelet-rich plasma therapy for postoperative esophageal fistula in a pediatric patient[J]. J Surg Case Rep, 2024, 2024(5):rjae350. DOI: 10.1093/jscr/rjae350.
[16] Debs T, Iannelli A, Frey S, et al. Mesenchymal stem cells and platelet rich plasma therapy to treat leak after sleeve gastrectomy[J]. J Surg Res, 2021, 268:405-410. DOI: 10.1016/j.jss.2021.06.066.
[17] Wu M, Lin H, Shi L, et al. Bronchoscopic treatment of tracheobronchial fistula with autologous platelet-rich plasma[J]. Ann Thorac Surg, 2021, 111(2):e129-e131. DOI: 10.1016/j.athoracsur.2020.05.047.
[18] 张晓琳,刘春芳,高娜.气管支气管瘘应用支气管镜下介入治疗的临床分析[J].中国实用医药,2019,14(6):20-21.DOI:10.14163/j.cnki.11-5547/r.2019.06.009.
[19] Abdollahi A, Emadi E, Hamidi Alamdari D. Autologous platelet-rich-plasma injection and platelet-rich fibrin glue interposition for treatment of anal fistula resistant to surgery[J]. Gastroenterol Hepatol Bed Bench, 2023,16(3):292-296. DOI: 10.22037/ghfbb.v16i2.2719.
[20] 孙英刚,杨光,朱元庆,等.自体单采富血小板血浆在直肠吻合口瘘治疗中的应用[J].中华普通外科杂志,2023,38(6):449-450.DOI:10.3760/cma.j.cn113855-20220808-00502.
[21] 孙英刚,张帅,朱元庆,等. 自体富血小板血浆在胃肠吻合口瘘治疗中应用现状及展望[J]. 临床军医杂志,2024,52(6):658-660. DOI:10.16680/j.1671-3826.2024.06.30.
[22] 刘嘉浩,李璐蓉,张伟锋,等. 内镜下注射自体富血小板血浆治疗难治性上消化道瘘8例临床分析[J]. 中华消化杂志,2023,43(11):741-746. DOI:10.3760/cma.j.cn311367-20230531-00260.

经支气管镜局部注射自体富血小板血浆治疗气管支气管瘘的效果

The effect of local injection of autologous platelet rich plasma via bronchoscopy in the treatment of tracheobronchial fistula

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