腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型气管支气管结核的临床研究

Clinical Study of Endovascular Intervention Combined with Silicone Stent Implantation in the Treatment of TypeⅣandⅤTracheobronchial Tuberculosis

目的:研究腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型气管支气管结核(TBTB)的临床效果。方法:选择2019年1月—2023年12月于江西省胸科医院治疗的20例Ⅳ、Ⅴ型TBTB患者。所有患者均采用腔内介入结合硅酮支架置入术治疗。观察治疗前后的临床疗效、呼吸困难程度、肺功能指标、血气分析指标、管腔直径变化及并发症发生情况。结果:20例Ⅳ、Ⅴ型TBTB患者治疗后的总有效率为95.00%(19/20)。治疗后,患者的改良英国医学研究委员会呼吸困难量表(mMRC)评分、二氧化碳分压(PaCO_(2))均低于治疗前,第1秒用力呼气容积(FEV1)、动脉血氧分压(PaO_(2))及管腔直径均高于治疗前,差异均有统计学意义(P<0.05)。20例Ⅳ、Ⅴ型TBTB患者治疗后并发症总发生率为10.00%(2/20)。结论:腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型TBTB效果确切,能够减轻患者呼吸困难程度,改善患者血气指标及肺功能,扩大管腔直径,且并发症发生率低。

Objective:To study the clinical effect of endovascular intervention combined with silicone stent implantation in the treatment of typeⅣandⅤtracheobronchial tuberculosis(TBTB).Method:A total of 20 patients with typeⅣand typeⅤTBTB treated in Jiangxi Chest Hospital from January 2019 to December 2023 were selected.All patients were treated with endovascular intervention combined with silicone stent implantation.The clinical effect,dyspnea degree,lung function index,blood gas analysis index,lumen diameter change and complications after treatment were observed.Result:The total effective rate of 20 patients with typeⅣand typeⅤTBTB after treatment was 95.00%(19/20).After treatment,the modified medical British Research Council scale(mMRC)score,partial pressure of carbon dioxide(PaCO_(2))were lower than those before treatment,and the forced expiratory volume in the first second(FEV1),arterial oxygen partial pressure(PaO_(2))and lumen diameter were higher than those before treatment,the differences were statistically significant(P<0.05).The complication rate of 20 patients with typeⅣand typeⅤTBTB after treatment was 10.00%(2/20).Conclusion:Intracavitary intervention combined with silicone stent implantation in the treatment of typeⅣand typeⅤTBTB has a definite effect,which can reduce the degree of dyspnea in patients,improve the blood gas analysis index and lung function of patients,expand the lumen diameter,and have a low complication rate.