球囊扩张气道成形术治疗结核性支气管狭窄

目的探讨经支气管镜介导下高压球囊扩张气道成形术对结核性支气管狭窄预后的影响。方法对15例气道狭窄患者实施高压球囊扩张气道成形术,在术前和最后一次球囊扩张后的当天对狭窄段气道直径、气促评分和第一秒用力呼吸容积(FEV1)进行测定。结果15例分别接受高压球囊扩张术1～9次,平均(2.8±2.14)次,即刻疗效达到100%。狭窄支气管的直径由治疗前的2.13±0.64mm增加到6.00±2.04mm(P<0.01);气促评分由术前的2.40±0.83,减少到0.6±0.74(P<0.01)。1例进行了FEV1检测,术前FEV10.693L,术后升至1.257L。经2～24个月的随访远期疗效达93.33%。有6例同时接受了微波治疗。胸痛6例;出血2例。结论经支气管镜介导下高压球囊扩张气道成形术对结核性近端气道狭窄进行干预性治疗,对支气管内膜结核的预后有积极的影响。

Results of bronchoplasty by fiberoptic bronchoscopic balloon dilation in the management of tuberculous tracheobronchial stenosis

Objective To explore the effect of balloon dilatation through fiberoptic bronchoscop in the management of tuberculous tracheobronchial stensis.Methods Fifteen patients were treated by balloon dilatation through flexible fiberoptic bronchoscopy. Before the procedure and immediately after the last operation, airway diameters, dyspnea index and complication were evaluated in all of the patients and FEV_1 was tested.Results 1 to 9 operations (2.8±2.14) were required to achieve satisfactory dilatation. After high-pressuer balloon dilatation, the average airway diameter increased from (2.13±0.64) mm to (6.00±2.04) mm (P<0.01). Dyspnea index decreased from 2.40±0.83, to 0.6±0.74(P<0.01). FEV_1 was increased from 0.693L to 1.257L.Conclusion Bronchoplasty by high-pressure balloon dilatation through flexible fiberoptic bronchoscopy is a effective method to treat tuberculosis tracheobronchial stenosis and have a active influence for the prognosis of endobronchial tuberculosis.