经支气管镜球囊扩张术治疗良性中心气道狭窄临床分析

目的探讨经支气管镜球囊扩张技术治疗良性中心气道狭窄的操作方法、安全性及有效性。 方法选择2014年6月至2018年6月达州市中心医院呼吸内科收治的良性中心气道狭窄患者67例，其中结核性狭窄61例，气管损伤性狭窄6例，对不同原因导致的气道良性狭窄患者进行球囊扩张治疗，并必要时联合其他介入治疗措施如冷冻治疗等。治疗结束后对气促评分、KPS评分、肺功能(FEV₁)、气管狭窄程度和并发症发生情况进行评价。 结果所有患者均在气管镜直视下进行球囊扩张治疗，同时进行冷冻治疗。67例患者中，共进行球囊扩张治疗324次。经过球囊扩张治疗后，短期观察狭窄段支气管均有内径增大，气促评分增加，症状缓解。对球囊扩张后气道扩宽的瘢痕狭窄患者随访观察，有18例气道扩宽后再次发生瘢痕挛缩，发生再次狭窄。所有患者中，扩张治疗出现胸痛12例，黏膜少许撕裂2例，无严重不良反应发生。 结论良性中心气道狭窄支气管球囊扩张治疗，近期疗效良好，远期疗效有待进一步评估。

Clinical analysis of transbronchoscopic balloon dilatation in treatment of benign central airway stenosis

ObjectiveTo investigate the operation, safety and efficacy of transbronchoscopic balloon dilatation in the treatment of benign central airway stenosis. MethodsSixty-seven patients with benign central airway stenosis treated in the Department of Respiratory Medicine of Dazhou Central Hospital from June 2014 to June 2018 were selected. Among them, 61 patients presented tuberculous stenosis and 6 patients showed traumatic tracheal stenosis. Balloon dilatation was carried out for the patients with benign airway stenosis induced by different causes, and other interventional therapies such as cryotherapy were combined if necessary. After the treatment, shortness of breath was scored, and KPS score, pulmonary function (FEV₁), degree of tracheal stenosis and the occurrence of complications were evaluated. ResultsAll the patients underwent balloon dilatation and cryotherapy under a bronchoscope. Among the 67 patients, a total of 324 times of balloon dilatation were performed. After balloon dilatation, enlarged inner diameter, increased score for shortness of breath, and relieved symptoms were observed in bronchial tubes with stenosis in a short term. Patients with airway widening and scarring stenosis after balloon dilatation were followed up, revealing re-scar contracture and re-stenosis after airway widening in 18 patients. In all the patients, balloon dilatation caused chest pain in 12 patients, slight mucosal tear in 2 patients, and no severe side effects. ConclusionTransbronchoscopic balloon dilatation in the treatment of benign central airway stenosis presents good short-term efficacy. However, the long-term efficacy needs further evaluation.