Therapeutic Effect Of Comprehensive Treatment Of Interventional Endoscopic Techniques For 41 Cases With Benign Central Airway Stenosis

Objective: To evaluate the short-term and long-term effects of bronchial tuberculosis and tracheal intubation stenosis after thermal ablation,balloon dilatation,cryotherapy combined with intravenous antibiotics,nebulized inhalation of budesonide,amikacin or isoniazid.Methods: Retrospective analysis of 41 cases with benign airway stenosis admitted to the Department of Respiratory Medicine,Second Affiliated Hospital of Guangxi Medical University from January 2015 to April 2019,who were treated with comprehensive treatment of interventional endoscopic techniques.First,all patients with benign airway stenosis receive thermal ablation,after that,balloon dilatation was implemented.The cryotherapy was carried out once after dilatation.The patients were treated with the intravenous antibiotics more than 1 month after surgery and with the atomized inhalation of budesonide,amikacin or isoniazid for 6 months.The bronchotuberculosis group was treated with isoniazid on the basis of anti-tuberculosis.The patients were followed up for 12 months,and the curative effect was evaluated by CT measurement of the anterior and posterior stenosis of the airway diameter and the shortness of breath.Results:A total of 66 effective balloon dilatation treatments were performed in 41 patients.averaging1.61±0.70 times.The short-term effect:26 cases of bronchial tuberculosis and stenosis,Bronchoin diameter before treatment(2.38±1.06)mm was compared with that at the time of expansion(7.88±1.72)mm,P<0.05.The comparison of dyspnea score was reduced from 1.12±0.52 to 0.50±0.51,P<0.05.15 cases of tracheal intubation tracheal stenosis,diameter before treatment(3.60±1.40)mm was compared with that at the time of expansion(11.79±1.19)mm,P<0.05.The comparison of dyspnea score was reduced from 2.87±0.74 to 0.73±0.46,P<0.05.The difference was statistically significant.The recent effective rate of both groups was 100%.Long-term efficacy:26 cases of bronchial tuberculosis and stenosis,8 cases(30.8%)were cured;12cases(46.2%)were effective,the overall effective rate was77%(20/26);6cases(23%)were ineffective.15 cases of tracheal intubation,6 cases(40%)were cured;8cases(53.3%)were effective,the overall effective rate was93.3%(14/15);1cases(6.7%)were ineffective.7 cases of ineffective treatment,one case was associated with Candida albicans infection,and the tracheal diameter was stable after antifungal infection and endoscopic intervention.The remaining 6 patients were followed up for treatment.Conclusions :Application of thermal ablation,balloon dilatation,cryotherapy combined with interventional endoscopic techniques,postoperative intravenous antibiotics,aerosolized budesonide,amikacin or isoniazid to prevent restenosis,is the treatment of bronchial tuberculosis and Effective means of tracheal intubation stenosis,it is worth of applying in clinical practice.