支气管结核经支气管镜冷冻治疗疗效及对免疫功能的影响

Bronchoscopy Freezing Treatment Curative Effect and It's Influence on the Immune Function by 105 Cases of Bronchial Tuberculosis

目的观察支气管镜冷冻治疗支气管结核的临床疗效及对免疫功能的影响。方法选取经支气管镜检查确诊为肉芽增殖型支气管结核的83例患者,采用在2HR(L_2)ZE(S)/10HR(L_2)E全身抗结核和异烟肼注射液雾化吸入治疗的基础上,加用支气管镜冷冻治疗,观察治疗前后的支气管镜下改变情况、临床症状及T淋巴细胞亚群变化情况。结果经支气管镜冷冻治疗后,显效率73.4%(61/83),有效率26.6%(22/83),总有效率为100%;气促分级显示治疗后患者气促症状较前明显好转(P<0.01);发热时间、咳嗽、咳痰时间以及全身乏力消失时间较对照组明显减少(P<0.01);治疗后发现观察组CD3^+、CD4^+和CD4^+/CD8^+水平均明显高于治疗前和治疗后的对照组,而CD8^+水平均明显低于治疗前和治疗后的对照组。结论经支气管镜冷冻治疗支气管结核患者疗效确切,不良反应少,安全性高。

Objective To observe the clinical effects of bronchoscope in the treatment of bronchial tuberculosis frozen and effects on immune function. Methods Eighty - three cases of Bronchial Tuberculosis in our hospital were enrolled,which composed of proliferating type. In addition to chemotherapy of tuberculosi 2HR （ L2 ） ZE （S）/10HR （ L2 ） E and pulverizing inhalation, endoscopic cryotherapy was received. The symptoms, endoscopic appearances and rentogenographic films before and after treatment were observed. Results 61 cases were very markedly effective（73.4% ） ,22 cases were general effective （26.6 % ） ,and the total effectiveness was 100%. According to the classification anhelation,the ignificant symptoms in patients after treatment was better. Fever, cough, sputum and fatigue disappear time were significantly reduced（P 〈 0.01 ）. CD3 ＋ ,CD4＋ and CD4 ＋/CD8 ＋ levels of the observation group were significantly higher than control group before and after treatment. The level of CD8 ＋ were significantly lower than that of before and after treatment of the control group. Conclusion The therapy of treating endobronchial tuberculosis with endoscopic cryotherapy has high curative effect, less adverse reaction. It is a safe method.