论文部分内容阅读
目的评价纤支镜介导下高压球囊扩张气道成形术治疗结核性气道狭窄对改善肺功能的作用。方法对24例因气管、支气管结核造成的不同部位近端气道狭窄患者,实施纤支镜介导下高压球囊扩张气道成形术,分别于术前和最后一次球囊扩张术后的当天,对患者的气促评分和肺功能各项参数如肺活量VC(%)、用力肺活量FVC(L)、第1秒用力呼气容积FEV1(%)、第1秒用力呼气容积/用力肺活量FEV1/FVC(%)等进行测定,并对其并发症的发生情况进行评价,设18例对照组患者进行治疗前后比较。所有患者均进行了12～24个月的随访。结果24例患者分别接受高压球囊扩张2～6次,平均接受球囊扩张(3.64±1.29)次。经过高压球囊扩张气道成形术后,气促评分由术前的(1.45±1.01),减少为术后的(0.45±0.59)(P<0.01)。术前平均FEV1(%)(81.47±10.07),上升为术后(96.03±10.79),差异有统计学意义(P<0.01);术前平均FEV1/FVC(%)及FVC(L)由(79.56±10.77)、(4.03±0.41),上升为术后(87.16±7.55)、(4.62±0.86)差异有统计学意义(P<0.05);而VC(%)由术前(77.01±19.35),上升为术后(79.24±15.15)差异无统计学意义(P>0.05)。对照组患者治疗前后肺功能各参数变化差异无统计学意义,治疗组12～24个月的随访,远期疗效达91.7%(22/24)。24例接受此方法治疗的患者,除3例出现了远端支气管黏膜轻微撕裂外,未见其他严重并发症发生。结论纤支镜介导下的高压球囊扩张气道成形术是一项有效、安全和简便的治疗结核性近端气道狭窄,改善肺功能的方法。
Objective To evaluate the effect of high pressure balloon dilation bronchoplasty on the treatment of tuberculous airway stenosis under the bronchofibroscope-mediated pulmonary function improvement. Methods Twenty-four patients with proximal airway stenosis caused by trachea and bronchial tuberculosis underwent balloon-assisted balloon-assisted airway hyperplasia under bronchoscopy. The patients underwent preoperative and post-primary balloon dilatation surgery respectively , The patient’s breathlessness score and pulmonary function parameters such as vital capacity VC (%), forced vital capacity FVC (L), forced expiratory volume 1 second FEV 1 (%), forced expiratory volume 1 second / forced vital capacity FEV 1 / FVC (%) were measured, and the occurrence of complications were evaluated, 18 patients in the control group were compared before and after treatment. All patients were followed up for 12 to 24 months. Results Twenty-four patients underwent balloon dilatation 2 ~ 6 times and balloon dilation (3.64 ± 1.29) on average. After high-pressure balloon-assisted airoplasty, the shortness of breath score decreased from (1.45 ± 1.01) preoperatively to (0.45 ± 0.59) postoperatively (P <0.01). The average preoperative FEV1 (%) was 81.47 ± 10.07 and increased to 96.03 ± 10.79 postoperatively (P <0.01). The mean preoperative FEV1 / FVC (%) and FVC 79.56 ± 10.77, 4.03 ± 0.41, 87.16 ± 7.55, 4.62 ± 0.86, respectively), and the difference between VC (%) and preoperative (77.01 ± 19.35) (79.24 ± 15.15), there was no significant difference (P> 0.05). There was no significant difference in the parameters of pulmonary function before and after treatment in the control group. The follow-up of 12 to 24 months in the treatment group was 91.7% (22/24). Twenty-four patients treated with this method showed no other serious complications other than mild tearing of distal bronchial mucosa in 3 patients. Conclusion High-pressure balloon-assisted balloon angioplasty guided by fiberoptic bronchoscopy is an effective, safe and simple method to treat tuberculous proximal airway stenosis and improve pulmonary function.