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目的评价纤维支气管镜下球囊扩张治疗结核性支气管狭窄的效果和安全性。方法回顾性分析25例纤维支气管镜下行球囊扩张的结核性支气管狭窄患者,于术前和最后一次球囊扩张后估计狭窄段的气道直径,并随访评价其长期疗效。结果 25例分别接受球囊扩张2～7次,平均(3.2±1.5)次。经球囊扩张后,狭窄段支气管管腔明显增大,由术前的(2.8±1.1)mm 增加为术后的(6.7±2.3)mm,即时疗效达100%,所有患者均未发生严重并发症,经过2～36个月的随访,未发生狭窄段的明显再狭窄。16例随访超过1年的患者,距最后一次扩张1年后气道直径为(5.5±2.0)mm,与最后一次扩张后气道直径无明显差别,比扩张前气道直径明显增加。出现肺不张的11例经球囊扩张后有2例完全复张。结论纤维支气管镜下球囊扩张治疗结核性支气管狭窄具有有效、安全和简便等优点。
Objective To evaluate the efficacy and safety of balloon bronchiectasis in the treatment of tuberculous bronchoconstriction. Methods Twenty-five patients with tuberculous bronchiectasis undergoing balloon dilation were retrospectively analyzed. The airway diameter of the stenosis was estimated before and after the last balloon dilation, and the long-term efficacy was evaluated at follow-up. Results 25 cases received balloon dilatation 2 to 7 times, with an average of (3.2 ± 1.5) times. After balloon dilatation, the bronchial lumen in the stenotic segment increased significantly from (2.8 ± 1.1) mm to (6.7 ± 2.3) mm postoperatively, with an immediate response rate of 100%. No serious complications occurred in all patients Symptoms, after 2 to 36 months of follow-up, no obvious stenosis of significant restenosis. Sixteen patients who were followed up for more than one year had a mean airway diameter of (5.5 ± 2.0) mm 1 year after their last dilatation, with no significant difference from the diameter of the airway after the last dilation, which was significantly larger than that before dilation. Atelectasis occurred in 11 cases after balloon expansion in 2 cases complete re-Zhang. Conclusion The treatment of tuberculous bronchial stenosis with bronchiectasis by fiberoptic bronchoscopy is effective, safe and easy.