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目的 :评价可弯曲支气管镜介导下高压球囊扩张气道成形术治疗近端气道良性狭窄的疗效和安全性。方法 :对 1 1 4例不同原因造成的不同部位近端气道的良性狭窄在纤维支气管镜 (纤支镜 )介导下行高压球囊扩张气道成形术 ,分别于术前和最后 1次球囊扩张术后的当天 ,测定患者狭窄段的气道直径、气促评分和 1秒钟最大呼气量 (FEV1 ) ,并对其并发症的发生情况进行评价。随访 2～ 4 6个月 (平均 2 4 .6个月 )。结果 :1 1 4例近端良性气道狭窄的患者分别接受高压球囊扩张气道成形术1～ 8次 ,平均 (3.2 2± 1 .2 4 )次。经过高压球囊扩张气道成形术后 ,狭窄段气管、支气管腔径明显增大 (P<0 .0 1 ) ,即刻疗效达1 0 0 %。气促评分明显降低 (P<0 .0 1 )。5 8例患者分别于术前及术后进行了 FEV1 的测定 ,术后 FEV1 也明显上升 (P<0 .0 1 )。经过 2～ 4 6个月的随访 ,远期疗效达 75 .4 3% (86 /1 1 4 )。 2 8例患者因肉芽组织过度增生或气管支气管软化而接受了冷冻、电凝、氩气刀或支架置入等联合治疗。 3例 (2 .6 3% )患者在治疗后发生了治疗一侧的少量气胸 ,其中 1例并发有纵隔气肿 ,均未做特殊处理自愈。有 8例出现了狭窄段远端支气管黏膜的轻微撕裂 ,余未见其他严重并发症发生。 结论 :纤支镜介导下的高压球囊扩张
OBJECTIVE: To evaluate the efficacy and safety of bendable bronchoscopic-assisted balloon angioplasty in the treatment of benign proximal stenosis. Methods: One hundred and forty-one patients with benign stenosis of proximal airway caused by different causes were treated with high-pressure balloon dilation bronchofibroscopy under bronchofibroscopy (bronchofiberscopy) On the day after balloon dilatation, airway diameter, shortness of breath score, and maximum expiratory volume in 1 second (FEV1) of the stenosed segment of the patient were measured and their complications were evaluated. The follow-up ranged from 2 to 46 months (mean, 24.6 months). Results: Totally 11 4 patients with proximal benign airway stenosis were treated with high pressure balloon dilatation and airway angioplasty one to eight times, with an average of (3.2 2 ± 1.24) times. After balloon angioplasty with high pressure, the diameter of the trachea and bronchus in the stenotic segment increased significantly (P <0.01), and immediate effect reached 100%. Stroke score was significantly lower (P <0. 01). Fifty-eight patients underwent FEV1 measurement before and after surgery, respectively, and postoperative FEV1 also increased significantly (P <0.01). After 2 to 46 months of follow-up, long-term efficacy reached 75.43% (86/114). Twenty-eight patients received combined treatment of freezing, electrocoagulation, argon knife or stent placement due to hyperplasia of granulation tissue or bronchoconstriction of the trachea. A small amount of pneumothorax occurred on the treated side in 3 patients (2.63%), of which 1 case had mediastinal emphysema without any special treatment. There were 8 cases of distal stenosis distal bronchial mucosal slight laceration, I did not see other serious complications. Conclusion: High-pressure balloon dilatation mediated by fiberoptic bronchoscopy