支气管镜介入治疗肺结核合并支气管结核老年患者的病灶吸收率和安全性

Analysis of focus absorption rate and safety of bronchoscopy interventional treatment of elderly patients with pulmonary tuberculosis complicated with bronchial tuberculosis

目的探讨支气管镜介入治疗肺结核合并支气管结核老年患者的病灶吸收率及安全性。方法选取2018年1月-2020年1月该院肺结核合并支气管结核的老年患者60例,按照不同治疗方式分为抗结核化疗药物联合支气管镜介入治疗组(ZQ组,n=32)和抗结核化疗药物治疗组(HL组,n=28),观察两组患者抗酸杆菌转阴率、肺部病变吸收好转情况、临床症状改善、药物不良反应发生情况和临床疗效。结果ZQ组治疗后镜下抗酸杆菌转阴率(93.75%)高于HL组(71.43%),组间比较,差异有统计学意义(χ^(2)=5.36,P=0.021);ZQ组体内共有24个空洞,HL组有22个空洞,治疗后ZQ组的空洞闭合率为45.83%、空洞缩小率为33.33%,均高于HL组,HL组空洞增大率为13.64%,高于ZQ组(4.17%),ZQ组总有效率(79.17%)高于HL组(45.45%),组间比较,差异有统计学意义(χ^(2)=5.59,P=0.018);ZQ组治疗后病灶显著吸收率和吸收率均高于HL组,组间比较,差异有统计学意义(χ^(2)=6.37,P=0.040);ZQ组肉芽增殖治疗有效率为100.00%,HL组为75.00%,两组比较,差异有统计学意义(χ^(2)=3.54,P=0.039);HL组和ZQ组的不良反应发生率分别为18.75%和17.86%,两组比较,差异无统计学意义(P>0.05)。结论采用支气管镜介入治疗肺结核合并支气管结核老年患者,能够明显提高患者抗酸杆菌转阴率和病灶吸收率,并有效改善病灶周围阻塞情况和支气管病变情况,达到较理想的临床疗效。

Objective To explore the focus absorption rate and safety of bronchoscopy interventional treatment of elderly patients with pulmonary tuberculosis complicated with bronchial tuberculosis.Methods From January 2018 to January 2020,60 elderly patients with pulmonary tuberculosis and bronchial tuberculosis were selected.According to different treatment methods,they are divided into anti-tuberculosis chemotherapy drugs combined with bronchoscopy intervention therapy group(ZQ group,n=32)and anti-tuberculosis chemotherapy drug treatment group(HL group,n=28).Observe the negative rate of acid-fast bacilli,the improvement of lung disease absorption,the improvement of clinical symptoms,the occurrence of adverse drug reactions,and the clinical efficacy of the two groups of patients.Results After treatment,the negative rate of acid-fast bacilli in the ZQ group(93.75%)was higher than that in the HL group(71.43%).The difference between the groups was statistically significant(χ^(2)=5.36,P=0.021);There were 24 cavities in the ZQ group and 22 cavities in the HL group.After treatment,the closure rate of the ZQ group was 45.83%and the shrinkage rate was 33.33%,which were higher than those of the HL group.The cavity enlargement rate in the HL group was 13.64%,which was higher than that in the ZQ group(4.17%).The total effective rate of patients in the ZQ group(79.17%)was higher than that of the HL group(45.45%).The difference between the groups was statistically significant(χ^(2)=5.59,P=0.018);The significant absorption rate and absorption rate of the lesions in the ZQ group after treatment were higher than those in the HL group,and the difference between the groups was statistically significant(χ^(2)=6.37,P=0.040);The effective rate of granulation treatment in ZQ group was 100.00%,and that in HL group was 75.00%.The difference between the two groups was statistically significant(χ^(2)=3.54,P=0.039);The incidence of adverse reactions in the HL group and ZQ group were 18.75%and 17.86%,the difference between the two groups was not statistically significant(P>0.05).Conclusion Bronchoscopy interventional treatment of elderly patients with pulmonary tuberculosis and bronchial tuberculosis can significantly increase the rate of negative conversion of acid-fast bacilli and the rate of lesion absorption,and effectively improve the obstruction around the lesion and the condition of bronchial disease,and achieve the ideal clinical effect.