纤维支气管镜下支气管球囊扩张术治疗良性支气管狭窄

目的评价局麻下采用纤维支气管镜(纤支镜)介导下支气管球囊扩张术治疗19例良性支气管狭窄的疗效和安全性。方法对19例良性支气管狭窄患者,根据狭窄部位、长度选择不同型号的球囊导管,实施球囊扩张术。于术前和最后一次球囊扩张术后当天,对狭窄段支气管直径、气促评分进行评估,测定FEV1、FVC值,并对患者进行随访。结果19例患者平均接受球囊扩张(2.3±1.3)次,均操作成功,扩张后支气管管径较前明显增大,症状明显缓解,即刻疗效达100%。术后狭窄段支气管直径、气促评分、肺功能指标(FEV1、FVC)均明显改善,无严重并发症。随访6￣32个月,远期疗效达84.2%。结论局麻下纤支镜介导的支气管球囊扩张治疗良性支气管狭窄简便、快速、安全、有效,值得临床推广应用。

Results of fiberoptic bronchoscopic balloon dilation in management of benign bronchial stenosis

Objective] To assess the effect and safety of balloon dilation using a fiberoptic bronchoscope in the management of benign bronchial stenosis. Methods] Balloon dilation was performed under local anesthesia via flexible bronchoscope in 19 consecutive patients with benign bronchial stenosis. Under direct visualization, a balloon catheter was inserted into the stenotic segment from the working channel and positioned across the stenosis, the balloon was inflated for 1 min to 3 min. Repeating inflation-deflation cycles were done if airway narrowing remained after the initial attempt. Results] All patients had initial success: increased airway dimensions and symptom relief. The average airway diameter, dyspnea classification and pulmonary function were all improved. After following for 6-32 months(mean, 18 months), 16 patients(84.2%) kept airway patency. There were no clinically significant complications. Conclusion] Fiberoptic Bronchoscopic Balloon Dilation under local anesthesia is a simple, rapid, safe and effective method to treat benign bronchial stenosis, and is valuable to spead.