肺功能检查在气管支气管结核中的应用

Clinical application of pulmonary function testing in the tracheobronchial tuberculosis

目的:探讨肺功能检查在EBTB诊断和疗效评估中的价值。方法 :回顾性分析38例EBTB患者,男3例,女35例,19～67岁。全部行肺通气功能检查,并比较10例经气管镜介入治疗患者治疗前后肺功能的变化。结果:FVC、FEV1和PEF占预计值百分比分别为(71.2±22.3)%、(56.4±22.3)%和(52.7±26.6)%,其异常率分别为68.4%、86.8%和97.4%。肺功能结果为正常、阻塞性、限制性和混合性的百分比为7.9%、23.7%、39.5%和28.9%。流量容积曲线的形态为正常型、阻塞型、限制型、混合型、大气道阻塞型、双蝶型的百分比分别为7.9%、15.8%、39.5%、13.2%、18.4%、5.3%。10例患者经气管镜治疗后FVC、FEV1、PEF均显著增高(P=0.023,0.011,0.006)。结论:EBTB可出现多种性质的通气障碍和典型的F-V曲线形态改变,尤以限制性为常见。气管镜介入治疗后肺通气功能有显著改善。

Objective To explore the value of pulmonary function testing in EBTB diagnosis and treatment evaluation.Methods Total 38 patients with tracheobronchial tuberculosis（3 males and 35 females,19 to 67 years old） were retrospectively analyzed.Spirometry testing were conducted for all cases.Changes in pulmonary function were compared between pre-and post-treatment for 10 cases underwent fibrobronchoscopy.Results Among the 38 subjects,FVC,FEV1 and PEF percent predicted were（71.2±22.3）%,（56.4 ±22.3）% and（52.7±26.6）%,respectively.The abnormality rate of FVC,FEV1 and PEF were 68.4%,86.6% and 97.4%,respectively.The percentages of normal,obstructive,restrictive and mixed pulmonary function were 7.9%,23.7%,39.5% and 28.9%,respectively.The percentages of the flow volume curves showed as normal,obstructive,restrictive,mixed,largeairway obstructive,double butterfly-like conformation were 7.9%,15.8%,39.5%,13.2%,18.4% and 5.3%,respectively.Significant increases in FVC（P = 0.023）,FEV1（P = 0.011） and PEF（P = 0.026） were observed in 10 cased underwent fibrobronchoscopy.Conclusions Multiple ventilatory defects and typical changes in flowvolume curve occur in the patients with tracheobronchial tuberculosis and the ＂restrictive＂ is the most common form in these patients.Significant improvement in pulmonary function could be achieved after fibrobronchoscopic therapy.