气管镜下球囊扩张联合曲安奈德局部注射治疗气道狭窄的远期疗效  

Long-term curative effect of balloon dilatation combined with triamcinolone acetonide through fiberoptic bronchoscopy on tracheobronchial stenosis

作　　者：雷小婷[1] 孟泳[1] 包爱华[2] 陈宇清[2] Lei Xiaoting;Meng Yong;Bao Aihua;Chen Yuqing(Henan Traditional Chinese Medicine Hospital,Zhengzhou 450000,China;Department of Respiratory Medicine,the First People’s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200080,China)

机构地区：[1]河南省中医院,郑州450000 [2]上海交通大学附属第一人民医院呼吸科,200080

出　　处：《中国实用医刊》2019年第4期11-14,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析气管镜下球囊扩张联合曲安奈德局部注射治疗气道狭窄的远期疗效及对患者第1秒最大呼气容积(FEV1)、血糖的影响。方法选取2017年1月至2017年12月上海交通大学附属第一人民医院南院20例良性气道狭窄患者,随机分成对照组和治疗组,每组10例。对照组应用纤维支气管镜介导下球囊扩张治疗,治疗组则应用纤维支气管镜介导下球囊扩张联合曲安奈德局部注射治疗,治疗后0.5、6个月分别观察两组患者的气道狭窄及气促改善情况,评价气管镜下球囊扩张联合曲安奈德局部注射的远期疗效及对FEV1、血糖的影响。结果20例患者均接受高压球囊扩张术2~4次,平均3次.治疗后0.5个月,对照组与治疗组在气道狭窄、气促改善及对FEV1的影响方面比较,差异未见统计学意义(P>0.05)。但治疗后6个月,对照组患者的再狭窄发生率高于治疗组,两组患者气道狭窄、气促改善及对FEV1的影响方面比较差异均有统计学意义(P<0.05)。治疗组应用曲安奈德局部注射对空腹血糖无明显影响,治疗前后比较差异未见统计学意义(P>0.05)。结论气管镜下球囊扩张联合曲安奈德局部注射在临床治疗气道狭窄中有明显疗效,且远期疗效显著,可减少球囊扩张次数,有效改善气道狭窄,安全性高,建议临床推广应用。Objective To analyze the long-term curative effect of balloon dilatation combined with triamcinolone acetonide through fiberoptic bronchoscopy on tracheobronchial stenosis and its effect on forced expiratory volume in one second(FEV1)and fasting blood glucose.Medthods Twenty patients with benign airway stenosis in the North Ares of the First People's Hospital Affiliated to Shanghai Jiao Tong University from January 2017 to December 2017 were randomly divided into control group and treatment group,with 10 cases in each group.The control group was treated with balloon dilatation guided by bronchoscopy.The treatment group was treated with balloon dilatation guided by bronchoscopy and local injection of triamcinolone acetonide.Airway stenosis and improvement in shortness of breath were observed in both groups half a month and six months after treatment.To evaluate the long-term efficacy of balloon dilatation combined with triamcinolone acetonide local injection under bronchoscopy and its effect on FEV1 and blood glucose were evaluated.Results Each of the 20 patients underwent high-pressure balloon dilatation 2-4 times,with an average of 3 times.Half a month after treatment,there was no significant difference in airway stenosis,dyspnea improvement or FEV1 between the control group and the treatment group(P>0.05).However,6 months after treatment,the incidence of restenosis in the control group was higher than that in the treatment group(P<0.05).There were significant differences in airway stenosis,shortness of breath improvement and the impact on FEV1 between the two groups(P<0.05).In the treatment group,local injection of triamcinolone acetonide had no significant effect on fasting blood glucose,and there was no significant difference before and after treatment(P>0.05).Conclusions Balloon dilatation combined with triamcinolone acetonide has obvious curative effect on tracheobronchial stenosis,of which the long-term effect is remarkable.It can reduce the number of balloon dilatation,effectively improve the tracheobronc

关 键 词：球囊扩张 曲安奈德 良性气道狭窄 

分 类 号：R56[医药卫生—呼吸系统]