球囊扩张联合支气管镜下电刀及冷冻治疗良性中心气道狭窄效果及安全性观察

Effect and safety of balloon dilatation combined with bronchoscope electrocautery and cryotherapy for benign central airway stenosis

目的探讨球囊扩张联合支气管镜下电刀及冷冻治疗良性中心气道狭窄的效果及安全性.方法将60例良性中心气道狭窄患者按照随机数字表法分为研究组和对照组,每组30例.两组均给予球囊扩张治疗,研究组联合支气管镜下电刀及冷冻治疗,观察住院全程.比较两组患者治疗前后气促评分、卡氏功能状态评分、气道管径、肺功能指标水平、临床疗效、并发症以及随访6个月良性中心气道狭窄复发情况.结果 治疗后两组气促评分较治疗前显著降低(P<0.01),卡氏功能状态评分显著升高(P<0.01),气道管径显著增大(P<0.01),用力肺活量及1秒用力呼气容积水平显著升高(P<0.01),研究组较对照组变化更显著(P<0.05或0.01).研究组总有效率显著高于对照组(P<0.05),两组并发症发生率比较差异无统计学意义(P>0.05),随访6个月研究组复发率显著低于对照组(P<0.05).结论球囊扩张联合支气管镜下电刀及冷冻治疗良性中心气道狭窄患者疗效显著,能有效缓解气促情况,增大气道管径及肺活量,降低复发率,值得在临床推广.

Objective To observe the effect and safety of balloon dilatation combined with bronchoscope electrocautery and cryotherapy for benign central airway stenosis.Methods 60 patients with benign central airway stenosis were divided into experimental group and control group by random number table method,30 cases in each group.The balloon was dilated for treatment.The experimental group was treated with bronchoscope electrocautery and cryotherapy.Before and after treatment,the shortness of breath score,KPS score,airway caliber,lung function index level,clinical efficacy,complications and benign central airway stenosis recurrence were compared between the two groups.Results After treatment,the shortness of breath scores of the two groups were significantly lower than before treatment(P<0.01),KPS score was significantly increased(P<0.01),airway diameter was significantly increased(P<0.01),FVC and FEV1 levels were significantly increased(P<0.01),the experimental group changed more significantly than the basic group(P<0.05 or 0.01).The total effective rate of the experimental group was significantly higher than that of the control group(P<0.05),there was no statistically significant difference in the incidence of complications between the two groups(P>0.05),and the recurrence rate of the experimental group after 6 months of follow-up was significantly lower than that of the control group(P<0.05).Conclusions Balloon dilatation combined with bronchoscope electrocautery and cryotherapy for patients with benign central airway stenosis has a significant effect,which can effectively relieve the shortness of breath,increase the airway diameter and lung capacity,and reduce the recurrence rate.It is worthy of clinical promotion.