经电子支气管镜球囊扩张及冷冻联合治疗结核性支气管狭窄的疗效分析

目的：探讨电子支气管镜球囊扩张及冷冻联合治疗结核性支气管狭窄的临床疗效及安全性。方法结核性支气管狭窄患者32例对其进行电子支气管镜球囊扩张及冷冻联合治疗，于术前和最后一次球囊扩张及冷冻治疗后当天，对狭窄段支气管直径、FEV1进行测定并进行气促评分、随访，观察治疗效果及并发症发生情况。结果32例患者经支气管镜球囊扩张及冷冻联合治疗后胸闷、呼吸困难及痰不易咳出等症状好转；患者治疗前气道内径为（4．93±1．54）mm，治疗后为（10．03±2．14）mm；气促评分治疗前为（2．75±0．84）分，治疗后为（0．93±0．66）分；FEV1治疗前为（1．56±0．47）L，治疗后为（2．46±0．47）分；治疗前后比较差异显著（P＜0．05）。32例患者均未出现气胸、大出血、支气管壁受压坏死、呼吸心跳骤停等严重并发症。结论电子支气管镜球囊扩张及冷冻联合治疗结核性支气管狭窄，方法安全、操作简便、疗效肯定，避免了大部分患者肺叶切除。

An Analysis of Combining Electronic Bronchoscope Balloon Dilatation with Cryotherapy on Treatment of Tuberculous Bronchial Stenosis

Objective To observe the effect and safety of combining electronic bronchoscopic balloon dilatation with cryotherapy on the treatment of tuberculous bronchial stenosis.Methods 32 patients with tuberculous bronchial stenosis in our department underwent the combined treatement with balloon dilatation and cryotherapy.Before operation and the last balloon dilata-tion and freezing the day after treatment, the stenosis bronchial diameter, FEV1 were meas-ured, then the follow-up score, shortness of breath,therapeutic effect and complications were observed.Results 32 patients with bronchoscopic balloon dilatation and cryotherapy after the combined treatment of chest tightness,dyspnea and difficulty in expectorating sputum and oth-er symptoms improved.The airway diameter of patients was （ 4.93＋1.54 ） mm before treat-ment, after treatment it was （10.03＋2.14） mm;dyspnea score before treatment was （2.75＋0.84）, after treatment it was （0.93＋0.66）;FEV1 before treatment was （1.56＋0.47） L, after treatment it was （2.46＋0.47） branch; Indicators for statistical analysis before and after treat-ment showed that the difference was statistically significant （ P〈0.05） , and the serious compli-cations of pneumothorax, bleeding, bronchial wall pressure necrosis, respiratory and cardiac arrest, severe chest pain were not seen in 32 patients.Conclusion It is safe, simple and effec-tive to treat tuberculous bronchial stenosis with electronic bronchoscopic balloon dilatation and cryotherapy while avoiding pulmonary lobectomy.