经支气管镜介入冷冻加注药治疗支气管结核疗效观察

Efficacy observation of patients with endobronchial tuberculosis treated by endoscopic interventional cryotherapy and drug infusion

目的探讨经支气管镜介入冷冻加注药治疗支气管结核的临床疗效。方法将该院136例溃疡坏死型及肉芽增殖型支气管结核患者随机分成两组,每组68例,两组均行全身抗结核及雾化治疗,治疗组同时行支气管镜下介入冷冻加注药治疗,对照组行支气管镜下注药治疗,观察治疗前后患者临床症状及支气管镜下的变化。结果 68例患者经过平均治疗(45.52±5.08)d,(6.38±3.02)次/例的支气管镜下冷冻加注药治疗,临床症状均明显改善,原气管、支气管病变绝大部分吸收。显效72.06%(49/68),有效27.94%(19/68),总有效率100%。结论经支气管镜介入冷冻加注药治疗可使溃疡坏死型及肉芽增殖型支气管结核患者咳嗽、胸闷症状快速缓解,加速气管、支气管局部病变的吸收及组织修复,疗效确切,并发症少,安全性高。

[ Objective ] To explore the effectiveness of treating endobronchial tuberculosis with endoscopic in- terventional cryotherapy and drug infusion. [Methods] 136 cases of endobronchial tuberculosis in our hospital were randomly divided into two groups, which composed of ulcerative necrotic type and proliferating type. Each group had 68 cases. In addition to chemotherapy and pulverizing inhalation for the two groups, endoscopic focal freezing and drug infusion was taken in the observational group, and drug infusion by tracheal endoscope in the control group. The changes of the symptoms and bronchoscopic features were analyzed. [ Results ] The 68 cases patient underwent （6.38±3.02） times cryotherapy and drug infusion in the mean course of （45.52±5.08） days, showed marked improve- ment in clinical symptoms and absorption of luminal foci in bronchi ; the regime was proved markedly effective in 72.06% of our cohort; effective in 27.94%, the total effective rate was 100%. [ Conclusions] Treating endobronchial tuberculosis with endoscopic interventional cryotherapy and drug infusion showed antitussive and relieve respiratory distress in short term, promoting the absorption of luminal foci and the reparation of tissue. So this therapy has defi- nite effect with less complications. It is a safe method.