摘要
目的探讨支气管镜下联合不同介入方法治疗良性中心气道狭窄的疗效及不良反应。方法对2011年4月~2017年4月经支气管镜介入治疗良性中心气道狭窄63例进行回顾性分析,支气管镜下联合电刀+球囊扩张+冷冻治疗36例为A组,支气管镜下电刀+球囊治疗27例为B组,随访术后即时、3个月、12个月的气道狭窄再通疗效和呼吸困难程度。结果 2组术后即时气道狭窄再通疗效、呼吸困难改善方面无统计学差异(P>0.05);术后3、12个月A组气道狭窄再通疗效、呼吸困难改善优于B组(术后12个月A组缓解、部分缓解、无效分别为30、5、1例,B组为14、12、1例,Z=-2.586,P=0.009;A组呼吸困难改良英国医学研究委员会分级0、1、2、3、4级分别为25、7、3、0、1例,B组为9、12、5、0、1例,Z=-2.641,P=0.008)。未发生大出血、气道壁穿孔、纵隔气肿等严重并发症。结论支气管镜下在电刀、球囊扩张基础上联合冷冻治疗良性中心气道狭窄安全有效,疗效提高。
Objective To compare the efficacy and safety of combined use of different bronchoscopic interventional procedures in the treatment of benign airway stenosis. Methods A retrospective analysis on 63 cases of benign airway stenosis from April 2011 to April 2017 was conducted. The patients were divided into either A group（ 36 cases,received electrocautery,bronchial balloon dilatation and cryotherapy） or B group（ 27 cases,received electrocautery and bronchial balloon dilatation）. The efficiency and safety were compared between the two groups at immediate treatment,3 and 12 months after the first treatment. Results No significant difference in the immediate effective rate was observed between the two groups（ P〉0. 05）. The efficacy of the group A in the 3 and 12 months after the first treatment was significantly better than that of group B（at 12 months after treatment,the remission,partial remission and no-effect were found in 30,5,and 1 patient in the group A and in 14,12,and 1 patient in the group B,respectively,Z =-2. 586,P = 0. 009; according to the British Medical Research Council classification,the improvement of dyspnea at grade 0,1,2,3,and 4 was found in 25,7,3,0,and 1 patient in the group A and in 9,12,5,0,and 1 patient in the group B,Z =-2. 641,P = 0. 008）. There were no hemoptysis,pneumothorax,mediastinal emphysema or other serious complications.Conclusion Combined use of bronchoscopic cryotherapy,electrocautery and bronchial balloon dilatation in the treatment of benign airway disease is effective and safe,and has low recurrence rate.
作者
涂力
汤洁
刘湘泸
宋卫东
徐平
Tu Li;Tang Jie;Liu Xianglu(Respiratory Department,Peking University Shenzhen Hospital,Shenzhen 518000,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第9期806-809,813,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
支气管镜
介入
良性
气道狭窄
Bronehoseopy
Interventional therapy
Benign
Aireay stenosis
