目的 评价经支气管镜下球囊扩张术治疗22例结核性支气管狭窄的临床疗效和安全性.方法 采用经支气管镜球囊扩张术对22例结核性支气管狭窄患者进行治疗,分别于治疗前后测定狭窄部位气道内径、肺功能、阻塞性肺炎吸收情况,并观察其相关并发症.术后随访时间3～24个月.结果 22例患者分别接受球囊扩张治疗3～ 19次,平均(6.8±3.6)次.扩张治疗前后狭窄部位气道平均内径分别为(2.81±0.65)mm,(6.31±1.49)mm(P ＜0.01).扩张后气促评分由(2.27±0.70)分降至(0.91±0.43)分(P＜0.01).扩张前后肺功能改变为FVC增加(0.48±0.18)L(P ＜0.01)；FEV1平均增加(0.40±0.12)L(P＜0.01)；PEF增加(0.62±0.31)L/S(P＜0.01).大部分患者仅有轻微胸闷、胸胀痛感或少量出血等并发症,均未发生严重并发症.所有患者均在治疗3个月后进行了2次以上随访,除未按要求(每周1～2次)完成治疗的1例患者外,其余患者患侧支气管均保持通畅,无阻塞性肺炎表现,远期疗效较满意.结论 经支气管镜下支气管球囊扩张术是一种微创、安全、有效、简便的治疗结核性支气管狭窄方法.%[Objective] To evaluate the bronchoscopic balloon dilation treatment of 22 cases of tuberculosis bronchial stenosis clinical efficacy and safety. [Methods] Bronchoscopic balloon dilatation in 22 cases of tuberculosis bronchial stenosis treatment .The airway diameter stenosis, pulmonary function, obstructive pneumonia and absorption were measured before and after treatment ,and its related complications were observed. Postoperative follow-up time was of 3~24 months. [Results] 22 patients were treated with balloon dilatation 3～19, an average of (6.8± 3.6) times. Expansion of the airway before and after treatment the average diameter stenosis was (2.81 ±0.65) mm, (6.31±1.49) mm (P<0.01). Most patients had only mild chest tightness, chest pain sense, a small amount of bleeding and other complications, no serious complications. All patients were treated for 3 months and followed-up 2 more times. There was one patient not to complete the treatment (1～2 times per week), the remaining patients remain ipsirnlateral bronchial smooth, non-blocking nature of pneumonia, long-term outcome is satisfactory. [Conclusion] The bronchoscopic bronchial balloon dilatation is a minimally invasive, safe, effective, simple method for tuberculosis bronchial stenosis.
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