经电子支气管镜氩等离子体凝固治疗支气管结核

Argon plasma coagulation via bronchofibroscopy in the treatment of endobronchial tuberculosis

目的探讨经电子支气管镜氩等离子体凝固(argon plasma coagulation,APC又称氩气刀)治疗支气管结核临床应用价值。方法应用ERBEAPC-300型治疗仪经电子支气管镜对25例支气管结核进行治疗,其中包括10例炎性浸润型,9例黏膜溃疡及干酪坏死型,3例肉芽增殖型,2例疤痕狭窄型,1例管壁软化型,其中2例疤痕狭窄型需结合高压球囊扩张气道成形术。从病灶狭窄处治疗后再通及临床症状改善进行疗效评价。结果 25例患者进行了61次APC治疗(2例1次,10例2次,13例3次)。完全有效20例(80%),部分有效2例(8%),轻度有效2例(8%),无效1例(4%)。结论经电子支气管镜APC治疗支气管结核是一种安全有效的方法。

Objective To evaluate the effectiveness of argon plasma coagulation（APC）via bronchofibroscopy in the treatment of endobronchial tuberculosis.Methods Totally 25 patients with endobronchial tuberculosis were treated with APC via bronchoscope,including 10 cases of exudative type,9 cases of ulcerative and caseating type,3 cases of granular hyperplasy type,2 cases of cicatricle type,1 case of bronchus collapse type.Two cases of cicatricle type also need balloon management.The efficiency was evaluated by making tracheostenosis recanalization and improving clinical symptom.Results The number treated by APC in the 25 patients was 61（one of 2 cases,two of 10 cases,three of 13 cases）.Full effectiveness was achieved in 20 cases（80%）,partial in 2 cases（8%）,mild in 2 cases（8%）,and none in 1 case（4%）.Conclusion APC via bronchoscope is an effective and safe method to treat endobronchial tuberculosis.