硬质支气管镜联合可弯曲支气管镜治疗淋巴结瘘型气管支气管结核所致中心气道狭窄2例

Rigid bronchoscopy combined with flexible bronchoscopy for treatment of central airway stenosis caused by tuberculous tracheobronchial fistula:report of 2 cases

淋巴结瘘型气管支气管结核由纵隔或肺门淋巴结结核破溃侵入气管支气管形成,破溃期通常需要在全身抗结核药物治疗的基础上接受可弯曲支气管镜下介入治疗。本文报道了2例淋巴结瘘型气管支气管结核所致中心气道狭窄的患者,因经可弯曲支气管镜治疗后疗效欠佳,故采用硬质支气管镜联合可弯曲支气管镜及冷冻、氩气刀等方式,对气道内病灶进行介入治疗,迅速解除了中心气道堵塞,且在保障安全的前提下,尽可能多地清除了病变淋巴结组织,促进了瘘口愈合。

Tuberculous tracheobronchial fistulas are caused by mediastinal or hilar tuberculous lymph nodes ulcerating into the trachea or bronchus.Patients usually require flexible bronchoscopic interventional procedures in addition to systemic anti-tuberculosis chemotherapy in the ulceration phase.In this paper,we reported 2 cases of central airway stenosis caused by tuberculous tracheobronchial fistula,which had poor treatment results after flexible bronchoscopy.According to the patients′condition,the airway lesions were treated by rigid bronchoscopy combined with flexible bronchoscopy,cryotherapy,argon plasma coagulation,and so on.The central airway stenosis was resolved quickly,and the caseating lymph node tissue was removed as much as possible under the premise of ensuring safety,which shortened the recovery time of tuberculous fistula.