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目的探讨纤维支气管镜介导下高压球囊扩张成形治疗结核性支气管狭窄的疗效。方法对28例气管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当天对狭窄气道直径、气促分数和第一秒用力呼吸容积(FEV1)和用力肺活量(FVC)进行测定。结果28例患者分别接受球囊扩张成形术2～7次,平均(3.34±1.22)次。即刻疗效达100%。扩张的支气管内径由扩张前(2.85±1.62)mm增加到(6.86±1.72)mm(P<0.01);气促评分平均值由术前(1.98±0.45)减少到(0.71±0.52)(P<0.01);FEV1由术前(1.32±0.62)L升至(1.78±0.14)L;FVC由术前(1.92±0.34)L升至(3.43±0.52)L(P<0.01)。胸痛21例,出血9例。结论经支气管镜介导下高压球囊扩张气道成形治疗结核性支气管殃窄安全、有效,对其预后有积极的影响。
Objective To investigate the curative effect of bronchofibroscope-mediated balloon dilatation on tuberculous bronchoconstriction. Methods Twenty-eight patients with tracheal stenosis underwent balloon-assisted balloon angioplasty. The diameters of the airway, the shortness of breath, the first-second forced expiratory volume (FEV1) and forced vital capacity (FEV1) were measured before and after the last balloon- (FVC). Results Twenty-eight patients underwent balloon angioplasty 2 ~ 7 times, with an average of 3.34 ± 1.22 times. Immediate effect of up to 100%. The mean bronchodilator diameter was increased from 2.85 ± 1.62 mm to 6.86 ± 1.72 mm before dilation (P <0.01), while the average value of shortness of breath decreased from 1.98 ± 0.45 to 0.71 ± 0.52 (P < 0.01). The FEV1 increased from (1.32 ± 0.62) L to (1.78 ± 0.14) L before operation and the FVC increased from (1.92 ± 0.34) L to (3.43 ± 0.52) L before operation (P <0.01). 21 cases of chest pain, bleeding in 9 cases. Conclusions The bronchoscopic-assisted balloon dilatation of bronchoplasty is safe and effective in treating tuberculous bronchial constriction, which has a positive effect on prognosis.