Luo L Z, Xiao Y B
Endoscopy Center, Hunan Province Chest Hospital, Changsha 410013, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Feb 12;47(2):137-140. doi: 10.3760/cma.j.cn112147-20230905-00139.
Tuberculous tracheobronchial fistulas are caused by mediastinal or hilar tuberculous lymph nodes ulcerating into the trachea or bronchus. Patients usually require flexible bronchoscopic interventional procedures in addition to systemic anti-tuberculosis chemotherapy in the ulceration phase. In this paper, we reported 2 cases of central airway stenosis caused by tuberculous tracheobronchial fistula, which had poor treatment results after flexible bronchoscopy. According to the patients' condition, the airway lesions were treated by rigid bronchoscopy combined with flexible bronchoscopy, cryotherapy, argon plasma coagulation, and so on. The central airway stenosis was resolved quickly, and the caseating lymph node tissue was removed as much as possible under the premise of ensuring safety, which shortened the recovery time of tuberculous fistula.
结核性气管支气管瘘是由纵隔或肺门结核性淋巴结溃破至气管或支气管所致。在溃疡期，患者除全身抗结核化疗外，通常还需要进行可弯曲支气管镜介入操作。本文报道了2例由结核性气管支气管瘘引起的中央气道狭窄患者，经可弯曲支气管镜治疗效果不佳。根据患者病情，采用硬质支气管镜联合可弯曲支气管镜、冷冻治疗、氩等离子体凝固术等方法对气道病变进行治疗。中央气道狭窄迅速缓解，并在确保安全的前提下尽可能多地清除干酪样淋巴结组织，缩短了结核性瘘管的恢复时间。
