经纤维支气管镜下注射异烟肼及丝裂霉素C治疗支气管结核及预防气道狭窄的研究

The study of injection with INH and Mitomycin C to treat bronchial tuberculosis and prevent airway constriction by fiberoptic bronchoscopy

目的 探索经纤维支气管镜下注射药物治疗支气管结核及预防狭窄的疗效与安全性.方法 纳入2010年10月～2012年12月患者40例,男11例,女29例,年龄18～50 岁,平均29岁.全部患者经纤维支气管镜确诊为支气管结核,在常规抗结核治疗的同时,每周进行纤维支气管镜下治疗,给予异烟肼0.2g局部注射,治疗2～8次不等,平均4.4次,以及一次丝裂霉素C 0.4mg/ml局部注射.治疗后观察气促等症状改善,测量气道直径、横截面狭窄率变化.结果 治疗后患者临床症状改善快,生活质量提高,无气道狭窄发生,随访1年病情稳定.结论 经纤维支气管镜下注射异烟肼及丝裂霉素C治疗支气管结核疗效确切,有效防止气道狭窄,安全可靠,值得临床推广.

Objective To explore the clinical effect and security of injection drugs for bronchial tuberculosis by fiberoptic bronchoscopy. Methods Forty patients were enrolled in this study from October 2010 to December 2012, including 11 male and 29 female. The average age was 29 years, ranged from 18 to 50 years old. All patients, on the basis of the conventional antituber- culosis chemotherapy, received the injection with INH 0. 2 by fiberoptic bronchoscopy once a week and Mitomycin C 0.4mg/ml one time. Injection with INH was performed 2 to 8 times in each person, 4. 4 times per patient on average. Symptom such as dysp- nea was observed and airway diameter, airway stricture rate were measured. Results After treatment, there were rapidly satisfac- tory improvement of clinic symptom and elevation of quality of life. During 1 year follow-up, condition was stable and airway con- striction wasn＇ t seen. Conclusion The injection with INH and Mitomycin C for bronchial tuberculosis by fiberoptic bronchoscopy was easy to perform with minimal wound. It was safe and reliable, so the treatment could be used generally to prevent airway con- striction in clinic.