支气管镜下冷冻联合球囊扩张及高频电刀治疗瘢痕狭窄型支气管结核的效果

Analysis of the Effect of Bronchoscope Cryotherapy Combined with Balloon Dilation and High-frequency Electrocautery on Scar Stenosis EBTB

目的探讨支气管镜下冷冻联合球囊扩张及高频电刀治疗瘢痕狭窄型支气管结核(EBTB)的效果。方法选取在2014年6月—2018年6月就诊的66例瘢痕狭窄型EBTB患者。随机将患者分成观察组和对照组,每组均为33例。其中,对照组给予支气管镜下冷冻联合球囊扩张治疗,观察组则实施支气管镜下冷冻联合球囊扩张及高频电刀治疗。对患者随访12个月,比较两组患者在治疗1个疗程后的治疗效果、不同时期的呼吸困难指数以及术后并发症的发生情况。结果两组患者在整体治疗效果上差异有统计学意义(Z=-5.919,P<0.001);观察组患者治疗效果的总有效率(100%)高于对照组(87.87%)(P<0.05)。在治疗结束时、治疗结束后3个月及12个月,观察组的改良英国医学研究委员会呼吸困难量表(mMRC)评分均低于对照组(P均<0.05)。两组患者在治疗结束时、治疗结束后3个月及12个月的mMRC评分均低于治疗前,且两组患者治疗结束后3个月及12个月的mMRC评分均低于治疗结束时(P均<0.05)。观察组患者术后并发症发生率(27.27%)与对照组(36.36%)差异无统计学意义(P>0.05)。结论支气管镜下冷冻联合球囊扩张及高频电刀治疗,有利于提高瘢痕狭窄型EBTB患者的治疗效果,改善患者的肺功能。

Objective To explore the effect of bronchoscope cryotherapy combined with balloon dilation and high-frequency electrocautery on the treatment of stenotic bronchial tuberculosis(EBTB). Methods Sixty-six patients with scar EBTB who came to our hospital from June 2014 to June 2018 were enrolled. Patients were randomly divided into observation group and control group by random number table method,and each group had 33 cases. The control group received subbronchial cryoablation combined with balloon dilatation,and the observation group underwent bronchoscopy with balloon dilatation and high-frequency electrosurgical knife treatment. The patients were followed up for 12 months,and the treatment effects of the two groups after treatment for one course of treatment,the dyspnea index at different periods and the occurrence of postoperative complications were compared. Results The overall treatment effect was significantly different between the two groups(Z=-5.919,P<0.05). The total effective rate(100%)of the treatment group was significantly higher than that of the control group(87.87%)(P<0.05). At the end of treatment,3 months after the end of treatment,and 12 months after the end of treatment, the m MRC score of the observation group was significantly lower than that of the control group(P all<0.05). The m MRC scores of the two groups of patients at the end of treatment,3 months after the end of treatment and 12 months after the end of treatment were significantly lower than before treatment,and the m MRC of the two groups of patients 3 months after treatment and 12 months after the end of treatment. The scores were significantly lower than that of the end of treatment(P all<0.05).There was no significant difference in the incidence of postoperative complications(27.27%)between the observation group and the control group(36. 36 %)(P>0. 05). Conclusion Bronchoscopy combined with balloon dilatation and high-frequency electrosurgical knife treatment is beneficial to improve the therapeutic effect of patients with scar EBTB and improve lung function.