经支气管镜球囊扩张术治疗良性气管狭窄

Results of fiberoptic bronchoscopic balloon dilatation in the management of benign tracheobronchial stenosis

目的评价局部麻醉下纤维支气管镜(纤支镜)介导下球囊扩张术治疗良性气管狭窄的疗效和安全性。方法对30例气管、支气管良性狭窄患者,根据狭窄部位、长度,选择不同型号的球囊导管,实施球囊扩张术。对球囊扩张后疗效、肺功能改善、并发症以及综合治疗方法进行分析。结果对30例患者进行球囊扩张,平均接受球囊扩张术(2.4±1.2)次,扩张后气管、支气管管径较前明显增大,症状明显缓解,即刻疗效达100%,术后狭窄段气管支气管直径、气促评分、肺功能指标均明显改善,无严重并发症。随访4～53个月。远期疗效达80.0%。结论局部麻醉下经纤支镜引导球囊扩张术治疗良性气管狭窄是一项安全、快速和有效的方法。

[Objective] To assess the effect and safety of balloon dilation using a fiberoptic bronehoseope in the management of benign tracheobronchial stenosis under local anesthesia. [ Methods ] Balloon dilation was performed via flexible bronehoscope in 30 consecutive patients with benign tracheobronchial stenosis. Under direct visualization, a balloon catheter was inserted into the stenotlc segment from the working channel and positioned across the stenosis, the balloon was inflated. We reviewed patient records and bronchoscopic findings. Clinical data, techniques performed, improvements of pulmonary function data, complications and results were recorded. [ Results ] All patients had initial success： increased airway dimensions and symptom relief. The average airway diameter, dyspnea classification and pulmonary function were all improved. After following for 4-53 months （29.1 ±10.4） months, 24 patients （80.0%） kept airway pateney. There were no clinically significant complications. [ Conclusion ] Fiberoptic bronehosoopic balloon dilation under local anesthesia is a rapid, safe and effective method to treat benign stenogis.