电子支气管镜直视下高压球囊扩张术在良性气道狭窄治疗中应用技巧

发布时间：2018-05-20 09:41

本文选题：良性气道狭窄 + 电子支气管镜　；参考：《实用医学杂志》2016年24期

【摘要】：目的:探讨电子支气管镜直视下高压球囊扩张治疗良性气道狭窄的操作方法、具体应用技巧及疗效。方法:对95例良性气管支气管狭窄的患者实施了高压球囊扩张治疗,扩张压力2~10 atm,一次扩张时间15~30 min,最长可达60 min。其中明确诊断为结核性支气管狭窄55例,支气管吻合口狭窄2例,原因不明确的38例。结核性支气管狭窄患者中,已停止抗结核治疗的35例,服药超过6个月12例,少于6个月的8例。所有患者于扩张前和最后一次扩张后当天测定扩张气道的直径,进行呼吸气促评分及肺功能测定(FEV1)。结果:95例患者分别接受了1~6次,平均(2.59±1.85)次/人的治疗,治疗间隔1~20周,扩张后狭窄气道管径重塑,扩张显著(P0.01),术后FEV1明显提高(P0.05),近期效果100%,远期效果85.7%(随访12个月),治疗过程中,低压扩张(2~5 atm)术后一般无特殊不适或少量痰中带血,高压扩张(6~8 atm)后部分患者有持续的胸骨后隐痛、少量咯血或痰中带血,均在1 d后消失。结论 :电子支气管镜直视下高压球囊扩张成型术是治疗良性气道狭窄安全有效的方法,值得临床推广应用。
[Abstract]:Objective: to explore the technique and effect of balloon dilatation under electronic bronchoscope for benign airway stenosis. Methods: 95 patients with benign tracheobronchial stenosis were treated with high-pressure balloon dilatation. The dilatation pressure was 210atm.The time of dilatation was 1530min, the longest time was 60 mins. Among them, 55 cases were diagnosed as tuberculous bronchial stenosis, 2 cases as bronchial anastomotic stenosis, 38 cases with unclear cause. Among the patients with tuberculous bronchial stenosis, 35 cases had stopped antituberculous therapy, 12 cases had taken drugs for more than 6 months, and 8 cases had been treated for less than 6 months. The diameter of dilated airway, respiratory shortness score and pulmonary function were measured before and after the last dilation. Results 95 patients received 6 times of treatment (mean 2.59 卤1.85) times per person. The interval of treatment was 1 to 20 weeks, and the diameter of the narrow airway was remodeled after dilatation. There was no special discomfort or a small amount of sputum with blood in sputum after dilatation. The short-term effect was 100, and the long-term effect was 85.7a (12 months follow up, during the course of treatment, there was no special discomfort or a small amount of sputum with blood in the middle of sputum). After hyperbaric dilatation (6 ~ 8 atm), some patients had persistent retrosternal pain, a small amount of hemoptysis or blood in sputum disappeared after 1 day. Conclusion: high pressure balloon dilatation under electronic bronchoscopy is a safe and effective method for the treatment of benign airway stenosis.
【作者单位】：兵团第七师医院呼吸内科;
【基金】：新疆生产建设兵团卫生科技项目(编号:2100499)
【分类号】：R653

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