关键词: 气管狭窄, 结核, 支气管, 气囊扩张术, 支气管镜检查

Abstract: Objective To assess improvement of pulmonary function in patients with tubercular tracheobronchial stenosis treated by balloon dilatation through fiberopile bronchoscopy.  Methods Twenty-four patients with proximal tracheobronchial stenosis induced by tracheobronchial tuberculosis were treated by high pressure balloon dilataion through flexible fiberoptic bronchoscopy. Before the procedure and immediately after the last operation, dyspnea index, pulmonary function parameters including VC(%)、FVC(L)、FEV1(%)、FEV1/FVC(%) were tested in all patients, and complications were also evaluated. These Results were compared with 18 cases before and after treatment as a control group. All patients were followed up for twelve to twenty-four months. Results 24 patients received 2 to 6 times of high pressure balloon dilataion respectively, the mean time was 3.64±1.29. After dilatation, dyspnea index decreased from 1.45±1.01 to 0.45±0.59(P<0.01), FEV1(%) increased from 81.47±10.07 to 96.03±10.79(P<0.01), FEV1/FVC(%) increased from 79.56±10.77 to 87.16±7.55（P<0.05）, FVC(L) increased from 4.03±0.41 to 4.62±0.86(P<0.05）, and VC (%) increased from 77.01±19.35 to 79.24±15.15(P>0.05).There were no significant changes in all above-mentioned parameters in the control group before and after balloon dilatation. The long-term effects were 91.67％(22／24) after follow-up for 12 to 24 months.No severe complications were found in all patients,except for 3 patients suffering from mild laceration at distal bronchial mucosa.  Conclusions Bronchoplasty by high-pressure balloon dilation through flexible fiberoptic bronchoscopy is a simple but effective and safe method to treat proximal tubercular tracheobronchial stenosis and to improve pulmonary function.

Key words: tracheal stenosis, tuberculosis, bronchi, balloon dilatation, bronchoscopy