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目的探讨经纤维支气管镜(纤支镜)球囊扩张治疗结核性支气管狭窄的疗效及安全性。方法对13例结核性支气管狭窄的患者实施经纤支镜球囊扩张术,同时对有结核活动的患者给予全身抗结核及经纤支镜局部注入抗结核药物。结果13例中10例扩张成功,狭窄段支气管直径由扩张前的(2.7±1.3)mm增加到扩张后的(5.8±1.7)mm(P<0.01)。3例失败。对扩张成功的10例患者进行6~18个月随访,10例患者术前有6例抗酸杆菌阳性,痰菌全部转阴;10例患者狭窄支气管均保持通畅。13例患者有8例术中诉轻度胸痛,均未见严重的并发症发生。结论经纤支镜球囊扩张术治疗结核性支气管狭窄是一项安全、有效和简便的方法,对于支气管狭窄引流不畅、痰抗酸杆菌反复阳性患者球囊扩张术可能为有效的治疗方法之一。
Objective To investigate the curative effect and safety of bronchiectasis treated with bronchofibroscope (bronchoscope) balloon dilatation. Methods Thirteen patients with tuberculous bronchial stenosis were treated with endovascular balloon bronchiectomy. At the same time, patients with tuberculosis were given systemic antituberculous and local injection of anti-TB drugs through fiberoptic bronchoscopy. Results Of the 13 cases, 10 cases were successfully expanded, and the diameter of the bronchus in the stenosis increased from (2.7 ± 1.3) mm to (5.8 ± 1.7) mm after dilatation (P <0.01). 3 cases failed. Ten patients with successful expansion were followed up for 6 to 18 months. Six patients were positive for acid-fast bacillus and all sputum were negative before surgery in 10 patients. All ten patients had smooth bronchial stenosis. Thirteen patients had mild chest pain in 8 cases, and no serious complication occurred. Conclusion The treatment of tuberculous bronchial stenosis by fiberoptic balloon dilatation is a safe, effective and simple method for the poor drainage of bronchial stenosis, sputum acid fast bacilli in patients with repeated positive balloon dilatation may be an effective method of treatment one.