支气管镜介入冷冻治疗对支气管结核患者痰菌转阴情况的危险因素分析

Analysis of sputum conversion and risk factors in bronchial tuberculosis patientswith bronchoscopic interventional cryotherapy

目的观察支气管镜介入冷冻治疗对支气管结核患者痰菌转阴情况及危险因素分析。方法选择2020年1月至2021年12月本院收治的支气管结核患者94例,根据治疗方案分为两组,对照组(抗结核化学药物治疗)47例,观察组(抗结核化学药物治疗联合支气管镜介入冷冻治疗)47例,两组均行相同护理措施。对比分析两组患者的临床疗效、症状改善时间、气道内径改变情况、痰菌转阴等,并进行痰菌转阴率危险因素分析。结果对照组的总有效率,明显低于观察组(74.77%vs.93.62%),差异有统计学意义(P<0.05),观察组的症状改善时间及气道内径改变情况优于对照组,差异有统计学意义(P均<0.05),治疗后2个月末痰菌转阴率,两组比较差异无统计学意义,治疗后6个月末对照组痰菌转阴率明显低于于观察组(87.23%vs.95.74%),差异有统计学意义(P<0.05),Logistic多因素分析,结果显示年龄、2个月末痰菌阳性和耐药程度是影响6个月末痰菌未阴转的危险因素。结论经支气管镜介入冷冻治疗支气管结核,可明显提高痰菌转阴率,缩短症状改善时间,改善气道内径改变情况。

Objective To observe the conversion of bronchial tuberculosis patients with sputum bacteria by bronchoscopic interventional cryotherapy and the analysis of risk factors.Methods 94 patients with bronchial tuberculosis admitted to our hospital from January 2020 to December 2021 were selected and divided into two groups according to the treatment:47 patients in the control group(antituberculosis chemotherapy)and 47 patients in the observation group(antituberculosis chemotherapy combined with bronchoscopic interventional cryotherapy),and both groups were treated with the same care measures.The clinical efficacy,sputum conversion,symptom improvement time,change in airway internal diameter and risk factors of conversion rate of the two groups were compared and analyzed.Results The overall effective rate of the control group was significantly lower than that of the observation group(74.77%vs.93.62%),and the difference was statistically significant(P<0.05).the improvement time of symptoms and change of airway internal diameter of the observation group were better than those of the control group,and the difference was statistically significant(P<0.05).The rate of sputum conversion in the control group was significantly lower than that in the observation group(87.23%vs.95.74%),and the difference was statistically significant(P<0.05).Logistic multi-factor analysis showed that age,sputum positivity at the end of 2 months and degree of drug resistance were the risk factors affecting the non-negative sputum conversion at the end of 6 months.Conclusion Interventional cryotherapy of bronchial tuberculosis via bronchoscopy can significantly increase the rate of sputum bacilli conversion,shorten the time of symptom improvement,and improve the change of airway internal diameter,with significant efficacy of clinical care.