支气管球囊扩张术在良性气管狭窄治疗中的应用

Application of bronchial balloon dilatation in benign tracheostenosis treatment

目的探讨纤维支气管镜（纤支镜）介导下支气管球囊扩张术治疗良性支气管狭窄的疗效和安全性。方法40例良性支气管狭窄患者，根据狭窄部位及长度选择不同型号的球囊导管实施球囊扩张术，于术前和末次球囊扩张术后当天对狭窄段气管内径、气促评分、一秒用力呼气容积（FEV1）值进行评估测定，并进行随访，对合并症的疗效及并发症发生情况进行评价。结果40例患者扩张后狭窄段气管内径由扩张前的（3．00±1．50）mm增加到（6．00±2．14）mm（P〈0．01），近期疗效达100％。气促评分由术前的（1．68±0．54）分降到（0．68±0．37）分（P〈0．01）。40例中36例于术前FEV1测定平均为（1．60±0．27）L,低于术后的（2．06±0．31）L（P〈0．01）。1例患者出现肺部大出血，经处理后出血停止；余无严重并发症。随访8-36个月，远期疗效达80％（32／40）。结论纤支镜介导的支气管球囊扩张术治疗良性支气管狭窄安全简便、创伤小、费用低、具有广阔的应用前景。

Objective To investigate curative effect and safety by fiber bronchoscope-guided bronchial balloon dilatation in the treatment of benigh tracheostenosis. Methods A total of 40 benign tracheostenosis patients received balloon dilatation with different size in accordance with different stenosis position and length. Evaluation was made on stenosis tracheal inner diameter, anhelation score and forced expiratory volume in 1 second （FEV1） before and after the last balloon dilatation, along with follow-up for curative effect and complications. Results All the 40 cases had increased stenosis tracheal inner diameter from （3.00 ± 1.50） mm before dilatation to （6.00 ± 2.14） mm after （P〈0.01）, and the short-term curative effect was 100%. Their anhelation score reduce from （1.68±0.54） points before treatment to （0.68 ± 0.37） points （P〈0.01）. There were 36 cases among 40 cases had mean FEV1 as （1.60 ± 0.27） L before operation, which was lower than （2.06 ± 0.31） L after operation （P〈0.01）. There was 1 case with massive pulmonary hemorrhage, which was stopped by treatment, and other cases had no severe complications. Follow-up for 8-36 months showed long-term Curative effect as 80% （32/40）. Conclusion Fiber bronchoscope-guided bronchial balloon dilatation contains safety, convenience, small trauma, low cost and wide application prospects in treating benign tracheostenosis.