纤支镜下介入治疗支气管结核54例疗效及安全性评价

Fiberbronchoscope interventional therapeutic evaluation in 54 cases of bronchial tuberculosis

目的:评价经纤支镜下多种方式介入治疗气管支气管结核的临床疗效及安全性。方法:在常规抗结核药物治疗的同时,对54例气管支气管结核患者进行纤支镜下吸引、钳夹及异烟肼喷洒、氩气刀、冷冻、球囊扩张等介入治疗并评价疗效。同时观察其中33例气道狭窄患者在治疗前后的气促指数及FEV1的变化。结果:54例患者均接受镜下异烟肼喷洒治疗,氩气刀治疗12例,冷冻治疗19例,球囊扩张治疗23例。治疗后显效45例,有效9例,总有效率100%。33例气道狭窄病例治疗前后的气促指数和FEV1数值差异均有统计学意义(P<0.05)。常见不良反应多为出血、咳嗽、术后发热等,无严重不良反应发生。结论:经纤支镜下多种介入方式联合治疗气管支气管结核疗效确切、安全性高、不良反应轻微,值得临床大力推广。

Objective： To evaluate the clinical efficacy and safety of interventional treatment of tracheobronchial tuberculosis through various ways under fibrobronchoscope. Methods： In the conventional anti-TB drug treatment, 54 cases of tracheobronchial tuberculosis patients were guided by fiberbronchoscope to attract,clamp and INH spraying,argon plasma coagulation,cryotherapy,balloon dilatation,and evaluate the efficacy of intervention. Of which 33 cases were observed in patients with airway stenosis before and after treatment dyspnea index and changes in FEV1. Results： All 54 patients received endoscopic spraying treatment of INH,argon plasma coagulation treatment of 12 cases,cryotherapy of 19 cases,ballon dilatation treatment of 19 cases. After treatment,45 cases markedly effective,general effective in 9 cases,the total efficiency of 100%. Thirty-three cases of numerical dyspnea index and FEV1 difference before and after treatment of airway stenosis were significant（ P〈 0. 05）. Conclusion： Various interventional therapy combination of bronchial tuberculosis through fibrotic bronchofiberscope are curative effect,high safety,mild adverse reaction,worthy of clinical promotion.