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目的探讨纤维支气管镜介导下球囊扩张术在治疗结核性气道瘢痕狭窄中的应用价值。方法在局麻下,对11例结核性气管支气管患者的13处瘢痕狭窄部位实施球囊扩张术,每周1次,连续2～4次。X线胸片、CT扫描动态监测手术前后气道开放以及肺复张情况。于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11例患者平均接受球囊扩张治疗2.7次,扩张后支气管管径较前明显增大,症状显著缓解,X线胸片和CT扫描显示肺复张,即刻疗效达100%,远期90.9%。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(P<0.05)。结论球囊扩张术治疗结核性气管支气管瘢痕狭窄操作简便、安全,疗效显著,可作为临床首选治疗方法。
Objective To investigate the value of balloon bronchiectomy under balloon bronchiectomy in the treatment of tuberculous airway scar stenosis. Methods Under local anesthesia, 13 cases of tuberculous tracheobronchial stenosis patients underwent balloon dilatation, once a week for 2 to 4 times. X-ray, CT scan dynamic monitoring of airway opening and lung recruitment before and after surgery. Stenotic airway diameter, shortness of breath, and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured on the day before surgery and after the last balloon dilation. Results 11 patients underwent balloon dilation for 2.7 times on average. After bronchiectomy, bronchial diameter was significantly increased and symptoms were relieved. X-ray and CT scan showed pulmonary recanalization with immediate effect of 100% and long-term 90.9% . The diameter of bronchus, shortness of breath, pulmonary function index (FEV1, FVC) in postoperative stenosis were significantly improved (P <0.05). Conclusions Balloon dilation is a safe, effective and effective method for the treatment of tuberculous tracheobronchial stenosis and can be used as the first choice of clinical treatment.