Gao Ping, Chen Zheng-xian, Guo Ji-quan, Huang Yu
Department of Respiratory Diseases, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Feb;31(2):369-72.
To study the value of high-frequency electrocautery combined with high-pressure balloon expansion in the treatment of benign airway obstruction.
Twelve patients with complete airway obstruction received treatment with high-frequency electrocautery and high-pressure balloon expansion, and 6 months of follow-up was performed.
After the initial treatment, the rate of airway obstruction relief exceeded 50% in 8 patients, who showed lung recruitment and an increased dyspnea index, suggesting total effectiveness; one patient showed mild improvement with airway stenosis relief by less than 50% (the upper-left lobe remained obstructed). Stents were implanted eventually in 7 patients for airway maintenance. Two patients showed relief of the airway obstruction by over 50% after the initial treatment, but lung recruitment or dyspnea relief failed to be achieved, suggesting non-response to the treatment. The airway failed to be found in 1 case (who received 5 previous operations of ablation and dilatation), which was considered a non-response case.
High-frequency electrocautery combined with high pressure balloon expansion is clinically effective with few complications in some cases of benign complete airway stenosis. The possibility of airway stenosis and even obstruction should be considered in patients with tuberculosis during the treatment.
探讨高频电灼联合高压球囊扩张术治疗良性气道梗阻的价值。
对12例气道完全梗阻患者采用高频电灼联合高压球囊扩张术治疗,并进行6个月的随访。
初始治疗后,8例患者气道梗阻缓解率超过50%,肺复张且呼吸困难指数增加,提示治疗总有效;1例患者改善轻微,气道狭窄缓解不足50%(左上叶仍梗阻)。最终7例患者植入支架以维持气道通畅。2例患者初始治疗后气道梗阻缓解超过50%,但未实现肺复张或呼吸困难缓解,提示治疗无效。1例患者(曾接受5次消融及扩张手术)气道未再通,视为治疗无效病例。
高频电灼联合高压球囊扩张术治疗部分良性完全性气道狭窄临床有效,并发症少。治疗结核病患者时应考虑气道狭窄甚至梗阻的可能性。