纤维支气管镜下球囊扩张术在治疗结核性气道瘢痕狭窄中的应用

摘要/Abstract

摘要： 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。

关键词: 结核/并发症, 气管狭窄, 气囊扩张术, 支气管镜检查

Abstract: Objective To investigate the clinical value of balloon dilatation through fiberoptic bronchoscopy in tuberculous tracheobronchial scar stenosis. Methods11 patients were treated with balloon dilatation through flexible fiberoptic bronchoscopy under local anesthesia once a week and repeated 2～4 times continuously. The chest X-ray and CT were used to observe the situation of airway open and pulmonary reexpansion. Before the treatment and immediately after the last operation, airway diameters, dyspnea index, FEV₁ and FVC were evaluated in all patients. ResultsThe average operation time of the balloon dilatation was 2.7 for per patient. After the operation, the bronchus diameter increased obviously, and the symptoms alleviated. The X-ray and CT showed the pulmonary reexpansion. The immediate curative effect reached to 100% and the long-term 90.9%. The bronchus diameter, dyspnea index, FEV₁ and FVC were improved significantly(P＜0.05). ConclusionBronchoplasty with ballnoon dilatation though flexible fiberoptic bronchoscopy is a handy, effective and safe method to treat tuberculosis tracheobronchial scar stenosis and can be preferred.

Key words: tuberculosis/complications, tracheal stenosis, balloon dilatation, bronchoscopy

张天华,余国政. 纤维支气管镜下球囊扩张术在治疗结核性气道瘢痕狭窄中的应用[J]. 中国防痨杂志, 2009, 31(6): 351-354.

Zhang Tianhua¹, Yu Guozheng². The application of balloon dilatation through fiberoptic bronchoscopy in tuberculous tracheobronchial scar stenosis[J]. Chinese Journal of Antituberculosis, 2009, 31(6): 351-354.

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