Observation of the clinical effectiveness of cryotherapy combined with balloon dilatation in the treatment of airway obstruction due to bronchial tuberculosis
冷冻联合球囊扩张治疗支气管结核所致气道梗阻的临床效果观察

摘要

目的 探讨冷冻联合球囊扩张治疗在支气管结核所致气道梗阻中的临床效果及安全性，并与单纯冷冻治疗进行对比分析。方法 本研究纳入2021年1月至2022年12月就诊于璧山区人民医院呼吸内科并确诊为支气管结核合并气道梗阻的40例患者，按照随机数字表法分为对照组（单纯冷冻治疗组，n=20）和观察组（冷冻联合球囊扩张治疗组，n=20）。所有患者均接受标准抗结核治疗，并在支气管镜下行相应的介入治疗。主要观察指标包括气道梗阻改善情况（通过支气管镜及气道CT评估）、总有效率（治愈率+有效率）、呼吸困难指数（MRC评分）及术后并发症发生情况。结果 研究结果显示，观察组的总有效率（95.0%）显著高于对照组（70.0%）（P<0.05），其中治愈率在观察组（60.0%）明显高于对照组（30.0%）。干预后，观察组的呼吸困难指数评分（3.91±0.57）高于对照组（2.83±0.61），差异具有统计学意义（P<0.001）。结论 冷冻联合球囊扩张治疗较单纯冷冻治疗在改善支气管结核所致气道梗阻方面更具优势，可提高治疗效率，改善患者呼吸困难症状，值得进一步推广。

Abstract

Objective To explore the clinical efficacy and safety of cryotherapy combined with balloon dilatation in the treatment of airway obstruction caused by bronchial tuberculosis, and to compare it with cryotherapy alone.
Methods This study included 40 patients diagnosed with bronchial tuberculosis complicated by airway obstruction who were admitted to the Respiratory Medicine Department of Bishan District People's Hospital from January 2021 to December 2022. The patients were randomly divided into a control group (cryotherapy alone, n=20) and an observation group (cryotherapy combined with balloon dilatation, n=20) using a random number table. All patients received standard antituberculosis treatment and underwent corresponding interventional therapy under bronchoscopy. The main outcome measures included improvement in airway obstruction (assessed by bronchoscopy and airway CT), overall response rate (cure rate + effective rate), Medical Research Council (MRC) dyspnea scale score, and postoperative complications.
Results The study results showed that the overall response rate in the observation group (95.0%) was significantly higher than that in the control group (70.0%) (P<0.05), with a significantly higher cure rate in the observation group (60.0%) compared to the control group (30.0%). After intervention, the MRC dyspnea scale score in the observation group (3.91±0.57) was higher than that in the control group (2.83±0.61), and the difference was statistically significant (P<0.001).
Conclusion   Cryotherapy combined with balloon dilatation is superior to cryotherapy alone in improving airway obstruction caused by bronchial tuberculosis, enhancing treatment efficiency, and alleviating dyspnea symptoms in patients. It is worthy of further promotion.