摘要目的 分析支气管热成形术(BT)治疗重症支气管哮喘术后近期(术后3周)呼吸不良事件发生情况.方法 2014年3月至2016年7月中日友好医院62例重症哮喘患者接受BT治疗,共完成183例次手术.收集术后3周内所有患者呼吸不良事件发生情况,分析可能影响术后不良事件发生的因素.结果 术后3周内62例患者中43例(69.4%)出现呼吸不良事件,87例次手术(47.5%)发生不良事件共153例次.主要不良事件为咳嗽(15例次,8.20%)、咳痰量增加(37例次,20.22%)、呼气峰值流量(PEF)短暂下降(37例次,20.22%)、胸闷(12例次,6.56%)、痰中带血丝(11例次,6.01%)、哮喘急性发作(10例次,5.46%)、肺炎(6例次,3.28%).多数不良事件在术后1周可自行缓解或经对症治疗消失.无气管插管、恶性心律失常及死亡等严重不良事件发生.患者基础诱导痰嗜酸粒细胞百分比、基础血嗜酸粒细胞百分比、手术次数及术前FEV1占预计值%会影响术后不良事件的发生.术前FEV1占预计值%≥60%可减少术后不良事件发生.结论 应用支气管热成形术治疗重症哮喘近期安全性良好.

abstractsObjective To analyze the short-term ( 3 weeks ) adverse respiratory events after bronchial thermoplasty ( BT) in patients with severe asthma.Methods The China-Japan Friendship Hospital recruited 62 patients with severe asthma for BT treatment from March 2014 to July 2016,with a total of 183 BT procedures.The data of adverse respiratory events within 3 weeks after procedure were collected to analyze the factors that might potentially influence the occurrence of adverse events .Results Forty-three patients (69.4%) experienced adverse respiratory events within 3 weeks after treatment.Totally 153 adverse respiratory events occurred after 87 procedures ( 47.5%) .The main adverse events were cough (15 events, 8.20%), sputum production (37 events, 20.22%), temporary PEF reduction (37 events, 20.22%), chest distress ( 12 events, 6.56%), blood in sputum ( 11 events, 6.01%), asthma exacerbation (10 events, 5.46%), and pneumonia (6 events, 3.28%) .Most events were relieved or resolved with standard therapy in 1 week.No severe adverse events including tracheal intubation , malignant arrhythmias or death occurred within 3 weeks after procedure.The baseline eosinophil percentage in induced sputum and blood, operation times, and preoperative FEV1(%predicted) might influence the occurrence of adverse events after treatment .Patients with preoperative FEV 1 (% predicted ) ≥60% had lower risk of adverse events.Conclusion BT showed a good security profile in treating patients with severe asthma within 3 weeks after procedure .