126例支气管结核肺复张影响因素分析

ANALYSIS OF THE FACTORS AFFECTING LUNG REEXPANSION IN 126 CASES OF BRONCHIAL TUBERCULOSIS

目的探讨支气管结核(EBTB)致肺不张患者影响肺复张的因素。方法回顾分析我院2008年1月～2009年12月确诊支气管结核致肺不张患者126例的临床资料,分析肺不张组和肺复张组的特点。结果肺复张组病程(3.5±1.2)个月,肺不张组病程(31.2±5.5)个月。两组比较有显著性差异(p<0.05)不同病理类型肺复张率分别为:炎症浸润型100.0%,溃疡坏死型73.8%,肉芽增殖型54.5%,瘢痕狭窄型51.9%,管壁软化型0。不同治疗方案肺复张率分别为:全身抗痨+气管雾化吸入(INH+SM)治疗23.7%,全身抗痨+气管雾化吸入(INH+SM)+支气管腔内介人治疗(钳夹、球囊扩展等)76.1%。两组治疗效果比较有统计学差异(p<0.05)。结论对支气管结核致肺不张患者的早期诊断,及在抗结核治疗的基础上,配合支气管镜下的腔内介入治疗,对提高肺不张患者的复张率有着重要作用。

Objective Investigate the affecting factors on lung reexpansion in bronchial tuberculosis （EBTB） caused atalectasis patient. Methods Retrospectively analyze the clinical data of 126 cases atelectasis patients caused by bronchial tuberculosis diagnosed in our hospital from2008 to2009. Analyze the characteristics of atelectasis group and lung reexpansion group. Results The course of lung group （ 3.5± 1.2） month, the course of atelectasis group （31.2 ± 5.5 ） month. Two groups have significant difference （p 〈 0. 05 ）. Different pathological types of lung reexpan- sion rates were： Inflammatory infiltration 100%, ulcers, necrosis type 79.6% , granulation proliferation of type 63.4%, cicatricial stenosis type 56. 5%, wall softening type 0%. The different treatment options lung reexpansion rates were： systemic anti -TB ＋ tracheal inhalation therapy （INH ＋ SM） 46. 5 %, systemic anti -TB ＋ tracheal in- halation （INH ＋ SM） ＋ bronchial cavity of interventional treatment （clamp, balloon expansion） 83.7%. Between the two groups of treatment there is statistical difference （p 〈 0.05 ）. Conclusion Early diagnosis of bronchial tu- berculosis caused atelectasis and bronchoscopic intra - cavity interventional treatment on the basis of anti - TB treat- ment play an important role to improve the reexpansion rate of atelectasis