经气管镜介入治疗结核性气道狭窄临床分析

目的 探讨目前经气管镜介入治疗结核性气道狭窄的临床效果、并发症及展望.方法 回顾性分析北京天坛医院2006年10月至2008年10月间经气管镜介入治疗结核性气道狭窄的临床资料.结果 目前的介入方法如氩等离子体凝固术、冷冻术、球囊扩张、金属支架放置等联合治疗结核性气道狭窄12例,全部即时效果理想,经治疗后胸闷、气促、咳嗽、咯痰等症状均明显好转,气道直径由治疗前的(2.71±1.89)mrn增加到(8.42±.75)mm(P<0.01).气促指数由治疗前的(2.83±1.14)减少到(0.83±0.69)(P <0.01).远期再狭窄率为75%,对再次介入治疗依然反应良好.结论 目前经气管镜介入治疗结核性气道狭窄是一种可供选择的治疗方法,但远期再狭窄发生率较高.

Clinical analysis of interventional bronchoscopy in management of tuberculous tracheobronchial stenosis

Objective To assess the clinical efficacy, complication and prospect of interventional bronchoscopictechniques in treating tuberculous tracheobronchial stenosis. Methods A retrospective analysis was conducted on clinical data of 12 patients with tuberculous tracheobronchial stenosis who were treated by interventional bronchoscopy in Beijing Tiantan Hospital. Results12 patients received interventional bronchoscopy,including argon plasma coagulation, cryotherapy, balloon dilatation, metallic stent placement. Bronchoscopic intervention provided immediate symptomatic relief in all of the patients. The average airway diameter increased from (2.71 ± 1.89) mm to (8.42± 1.75) mm(P <0.01). Dyspnea index decreased from (2.83±1.14) to (0.83±0.69) (P <0. 01). But restenosis occurred in nine patients(75%). Conclusions lnterventional bronchoscopy should be considered to be feasible for management of tuberculous tracheobronchial stenosis. However, repeated sessions may be required to maintain this improvement because of restenosis.