One case of pulmonary lesion complicated with bronchial stenosis caused by non-tuberculous mycobacterium infection treated by airway stenting
非结核分枝杆菌感染导致肺毁损合并支气管狭窄经气道支架治疗1例

摘要

非结核分枝杆菌感染可能导致肺部结构破坏，会引起肺组织出现气道狭窄、空洞形成、支气管扩张、肺毁损等结构性肺病表现，将导致患者肺功能急剧下降，同时出现肺动脉高压、咯血、混合感染、呼吸衰竭等情况的发生，最终导致治疗难度的增大及住院时间的延长。2022年汕头市第三人民医院ICU收治了一例非结核分枝杆菌感染导致肺毁损并发支气管狭窄的患者。患者因呼吸衰竭需机械通气，后因撤机困难，采用气道支架置入术解除气道狭窄，最终成功撤机并出院。本文通过介绍该病例的救治过程，希望能为结核性肺毁损合并气道狭窄在气道介入治疗方面提供新的治疗经验，对此类患者行支架置入的时机的选择及治疗效果有一定参考意义。

Abstract

Non-tuberculous Mycobacterium (NTM) infections can lead to structural damage in the lungs, resulting in conditions such as airway stenosis, cavity formation, bronchiectasis, and pulmonary destruction, which are manifestations of structural lung disease. These conditions can cause a rapid decline in lung function, and patients may also experience pulmonary hypertension, hemoptysis, mixed infections, respiratory failure, and other complications, ultimately increasing the difficulty of treatment and prolonging hospital stays. In 2022, the Intensive Care Unit of Shantou Third People's Hospital admitted a patient with pulmonary destruction and bronchial stenosis caused by non-tuberculous Mycobacterium infection. The patient experienced difficulties in weaning off the ventilator following mechanical ventilation due to respiratory failure. After experiencing difficulty in weaning off the ventilator, an airway stent placement procedure was performed to alleviate airway stenosis, which ultimately led to successful weaning and discharge. This article introduces the treatment process of this case, hoping to provide new therapeutic experience in the field of airway intervention treatment for tuberculosis-related pulmonary destruction combined with airway stenosis. The timing of stent placement and the therapeutic effects have certain reference significance for such patients.