改良球囊导管扩张治疗支气管结核性瘢痕狭窄25例疗效分析

Efficacy analysis of the improved balloon dilation of bronchial stenosis on 25 patients with tuberculous scar

目的探讨传统及改良球囊导管扩张治疗支气管结核性瘢痕狭窄的疗效及安全性。方法25例已确诊的支气管结核性瘢痕狭窄患者,10例患者采用传统球囊扩张术治疗,15例患者给予改良球囊扩张术治疗,分别给予患者传统球囊扩张术或改良球囊扩张术,每周治疗一次连续4周,并于第1~4周、5、9、13周分别测量狭窄段气道直径,狭窄部截面积、长度,气促评分、KPS等指标,并进行疗效评价。结果两组患者支气管球囊扩张治疗后气管明显扩张,扩张后气管最狭窄处直径改良组较传统组改善明显（9.43±0.42 mm vs.8.21±0.39 mm,P〈0.05）,改良组与传统组气管最狭窄处截面积（0.93±0.40）cm2vs.（0.59±0.38）cm2,狭窄部位长度传统组为（1.53±0.41）cm vs.改良组（1.94±0.57）cm。疗效较好,结果具有统计学意义（P〈0.05）。结论改良球囊导管扩张术治疗支气管结核性瘢痕狭窄较传统球囊扩张术更安全、有效、预后良好。

Objective To evaluate the efficacy and safety of traditional and improvemented balloon dilatation treatment for bronchial stenosis scar tuberculous. Methods A total of 25 cases of tuberculous bronchial stenosis scar has been diagnosed,and the patients were treated with improvement（ 10 cases） or conventional balloon dilation（ 15 cases） of bronchial stenosis every week for four weeks. In the first 1-4,5,9,and 13 weeks,it was measured that narrow segment of airway diameter,narrow sectional area,length,shortness of breath score,KPS and other indicators for efficacy evaluation. Results Bronchus balloon dilated trachea of the two groups’ patients,and the improved group expansion tracheal stenosis diameter（ 9. 43 ± 0. 42 mm vs. 8. 21 ± 0. 39 mm,P 〈 0. 05） and cross-sectional area（ 0. 93 ± 0. 40 cm2 vs. 0. 59 ± 0. 38 cm2） than the traditional group expanded significantly,stricture length（ 1. 53 ± 0. 41 cm vs. 1. 94 ± 0. 57 cm） was significantly shorter. Conclusion The improved balloon dilatation treatment were safer and effective with a good prognosis for the treatment of bronchial stenosis scar tuberculous than conventional balloon dilatation.