经纤维支气管镜冷冻辅助治疗支气管结核的疗效

Effects of interventional therapy for bronchial tuberculosis with cryotherapy via fibre bronchoscope

目的探讨经纤维支气管镜冷冻辅助治疗支气管结核的临床疗效。方法选取石家庄市第五医院2012年1月至201 3年6月收治的100例支气管结核患者作为研究对象,随机分为试验组和对照组各50例。两组患者均接受异烟肼0.3 g/d、利福70.45 g/d、吡嗪酰胺0.5 g/d和乙胺丁醇0.75 g/d（HRZE）常规治疗方案,试验组患者在此基础上加用经纤维支气管镜冷冻辅助治疗,对照组患者在常规治疗基础上采用传统纤维支气管镜治疗,治疗6个月后比较两组患者的痰菌阴转率、CT检查结果和纤维支气管镜检查结果。结果经过治疗后,试验组患者阴转率达92.3%,显著高于对照组的67.4%,差异具有统计学意义（χ^2=7.694、P〈0.01）。CT复查发现试验组患者共46例患者有效,总有效率为92.0%,显著高于对照组患者的66.0%（χ^2=10.186、JP〈0.01）。纤维支气管镜检查中试验组共47例患者有效,总有效率为94.0%,显著优于对照组,且差异有统计学意义（χ^2=7.441、P〈0.01）。两组患者中支气管炎型和溃疡坏死型治疗有效率相近,但试验组肉芽增生型和瘢痕狭窄型有效率显著优于对照组,差异具有统计学意义（χ^2=7.894、P〈0.05）。结论支气管结核应用经纤维支气管镜冷冻辅助治疗可显著提高治疗效果,特别是对于肉芽增生型和瘢痕狭窄型治疗效果较好。

Objective To investigate the effects of interventional therapy for bronchial tuberculosis with cryotherapy by fibre bronchoscope.Methods Total of 100 cases with bronchial tuberculosi were selected in the Fifth Hospital of Shijiazhuang between January 2012 and June 2013.The 100 patients were divided into experimental group and control group with 50 cases each group,randomly.The experimental group were treated with cryotherapy via fibre bronchoscope,wihile the control group were treated with traditional fibre bronchoscope.The phlegm germ feminine changed rate,CT examination results,and fiber endoscopy results in the two groups after 6 months of treatment were compared,respectively.Results After6 months of treatment,the putum negative conversion rates of patients in experimental group were 92.3%,which was significantly higher than that in the control group（χ^2 = 7.694,P 〈0.01）.The results of CT found that the total efficiency of experimental group was significantly higer than that in the control group（χ^2 =10.186,P〈 0.01）.The results of fibre bronchoscope found that the total efficiency of experimental group was higer than that of the control group,with significant differences（χ^2= 7.441,P 〈0.01）.The efficiency of bronchitis and ulcer necrosis between two groups were similiar,but the efficiency of experimental group on hyperplasia of granulation tissue and scar stenosis were better than that of the control group（χ^2 = 7.894,P〈 0.05）.Conclusions Bronchial tuberculosis application by bronchoscopy mirror frozen adjuvant therapy could significantly improve the effect of treatment,especially for granulation hyperplasia and scar stricture.