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目的:通过科学合理的设计,采用配对研究,进行多项指标观察测量,客观评价经支气管镜高压球囊扩张治疗临床疗效,为进一步改进扩张治疗方法进行科研积累。方法:球囊扩张组选择进行球囊扩张术的患者30例,对照组配对选择年龄、性别、狭窄程度相似,但不愿进行球囊扩张的30例结核性支气管狭窄患者,比较两组治疗前后气道内径、气促评分、肺复张、肺功能、综合疗效及并发症方面的差异。结果:治疗前两组相比较气道内径差异不具有显著性(P>0.05)。治疗后球囊扩张组与治疗前相比差异有统计学意义(P<0.05),与对照组相比较差异也有统计学意义(P<0.05);从临床症状改善情况来看,治疗前两组相比较差异不具有显著性(P>0.05),说明两组具有可比性。治疗后及治疗后3、6个月,球囊扩张组与治疗前相比、与对照组相比差异均具有统计学意义(P<0.05),但治疗后与治疗后3、6个月比较,差异无统计学意义(P>0.05);分别在治疗前、治疗后进行CT检查肺复张情况的评价,球囊扩张组肺复张情况显著优于对照组(P<0.05);在治疗前、治疗后进行肺功能检查评价两组肺功能变化的情况,治疗组治疗后FEV1与FVC较治疗前及对照组具有显著性差异(P<0.05);综合疗效评价结果治疗组与对照组相比较疗效有差异性(P<0.05),治疗组优于对照组治疗组未出现气胸、大出血等严重并发症,80%(24/30例)患者术中、术后仅感轻度胸闷不适及有少量出血,未经药物治疗,休息l~2 d后自行缓解。结论:经支气管镜高压球囊扩张治疗气道结核性狭窄的疗效显著、安全可靠、并发症少,但操作需要耐心细致。
OBJECTIVE: Through scientific and rational design, using paired research to observe and measure a number of indicators, objective evaluation of the clinical efficacy of bronchoscopic balloon dilatation therapy for scientific research to further improve the expansion of treatment methods. Methods: Thirty patients with balloon dilatation were enrolled in the balloon dilatation group. The control group was matched with 30 patients with tuberculous bronchial stenosis who were similar in age, gender, and stenosis but not willing to balloon dilatation. Before and after treatment Airway diameter, shortness of breath score, lung recruit, pulmonary function, comprehensive efficacy and complications. Results: There was no significant difference in airway diameter between the two groups before treatment (P> 0.05). There was significant difference between the two groups (P <0.05), the difference between the two groups was also statistically significant (P <0.05). From the clinical symptom improvement, the former two groups Compared with the difference was not significant (P> 0.05), indicating that the two groups are comparable. After treatment and at 3 and 6 months after treatment, the difference between the balloon-dilated group and the control group was statistically significant (P <0.05), but after 3 and 6-month after treatment , Respectively. There was no significant difference between the two groups (P> 0.05). Before and after treatment, the CT examination of pulmonary recanalization was evaluated. The situation of pulmonary recanalization in balloon dilation group was significantly better than that in control group (P <0.05) Before and after treatment, pulmonary function tests were performed to evaluate the changes of pulmonary function in both groups. The FEV1 and FVC in the treatment group were significantly different from those before treatment and in the control group (P <0.05). The results of comprehensive evaluation of the treatment group and the control group (P0.05) .There was no serious complications such as pneumothorax and hemorrhage in the treatment group and 80% (24/30 cases) patients in the treatment group had mild or severe chest discomfort A small amount of bleeding, without medication, rest l ~ 2 d self-remission. Conclusion: The bronchoscopic balloon dilatation for the treatment of airway tuberculous stenosis has obvious curative effect, safety and reliability, few complications, but the operation needs patience and meticulous.