可弯曲支气管镜腔内介入治疗支气管结核的临床应用

Clinical analysis of interventional treatments to bronchial tuberculosis though flexible bronchoscope

目的探讨可弯曲支气管镜(简称支气管镜)腔内介入治疗支气管结核的疗效和安全性。方法68例支气管结核患者均予以全身抗结核药物治疗,并经纤维支气管镜行病变部位灌注异烟肼及球囊扩张、高频电和冷冻等腔内介入治疗,观察治疗效果并测定40例支气管狭窄患者治疗前和治疗后的气道直径、气促指数及FEV1。结果68例患者中行支气管镜下气道病变部位灌注异烟肼治疗54例,高频电刀治疗10例,冷冻治疗6例,40例支气管狭窄的患者接受了126次的球囊扩张治疗。显效58例,有效10例。40例支气管狭窄患者治疗后狭窄段气道直径、气促评分、FEV1明显改善。全组无严重并发症。结论可弯曲支气管镜下抗结核药灌注联合球囊扩张、高频电刀和冷冻等腔内介入治疗支气管结核微创、安全、有效,应作为支气管结核治疗的首选方法。

Objective To observe the efficacy and safety of interventional treatment to bronchial tuberculosis though flexible bronchoscope. Methods 68 bronchial tuberculosis patients were treated with anti-tuberculosis drugs combined with interventional treatments include local injected INH, balloon dilatation, electrocautery and cryotherapy though flexible bronchoscope. The treatment effect, airway diameters, dyspnea index and lung function （FEV1） were evaluated. Results There were 54 cases accepted local injected INH in the airway, 10 cases accepted electrocautery, 6 cases accepted cryotherapy, 40 cases with bronchial stenoses accepted 126 times balloon dilatation treatments. There were 58 and 10 cases with excellence and effectiveness, respectively. There were obvious changes of the airway diameters, dyspnea index and FEV1 after the jointly use of interventional treatments. There were no severe complications of the interventional treatments. Conclusion The interventional treatments include local injected INH, balloon dilatation, electrocautery and eryotherapy though flexible bronchoseope to bronchial tuberculosis are minimally invasive, safe and effective, which may be the first choice in the treatment to bronchial tuberculosis.