纤维支气管镜下冷冻联合高压球囊扩张治疗瘢痕狭窄型气管支气管结核的效果观察

摘要

Objective To observe the treatment efficacy and safety of freezing and balloon dilating under the bronchoscope.Methods Select ninety patients who were diagnosed as tracheobronchial tuberculosis with cicatricial stenosis from January 2012 to August 2015.These patients were divided into three groups, each group inducing 30 people.All patients in the three groups were treated by bronchoscopic intervention on the basis of routine anti-tuberculosis treatment.They were treated with cryotherapy(frozen group), balloon dilation(balloon group)and cryotherapy plus balloon dilation(combined group),once every two weeks, a total of four times.To evaluate the treatment efficacy under the therapeutic schedule after one month.The main symptom classification, forced expiratory volume(FEV1) and airway diameter were compared before and after the treatment,and the complication was observed.Results The total effective rate was 90.0% in the combined group and 60.0% in the frozen group and 70.0% in the balloon group, the difference was statistically significant (P<0.05).The FEV1 and airway diameter of the three groups were improved (P<0.05), and the improvement of FEV1 and airway diameter was more obvious than that of the other two groups after treatment (P<0.05).There were no serious complications in the three groups.Conclusion Compared with single bronchoscopic interventional therapy, the combination of cryotherapy and balloon dilation was more effective in treatment TBTB with cicatricial stenosis.%目的 观察纤维支气管镜下冷冻联合高压球囊扩张治疗瘢痕狭窄型气管支气管结核(tracheobronchial tuberculosis, TBTB)的效果及安全性.方法 选择2012年1月-2015年8月确诊的瘢痕狭窄型TBTB患者90例,随机分为3组,每组30例.3组均在常规抗结核治疗基础上行支气管镜下介入治疗:冷冻治疗(冷冻组)、高压球囊扩张治疗(球囊组)和冷冻联合高压球囊扩张治疗(联合组),每2周治疗1次,共治疗4次.1疗程结束后1个月评价疗效,比较治疗前后主要症状分级、第1秒用力呼气容积(FEV1)及气道直径变化,以及并发症发生情况.结果 联合组临床总有效率为90.0%高于冷冻组的60.0%和球囊组的70.0%,差异有统计学意义(P<0.05).3组治疗后主要症状分级、FEV1、气道直径较治疗前均有所改善(P<0.05),且治疗后上述指标联合组较其他两组改善更为明显(P<0.05).3组治疗后均无严重并发症发生.结论 相较单一支气管镜下介入治疗,冷冻联合高压球囊扩张治疗瘢痕狭窄型TBTB效果更佳.