摘要
目的探讨支气管动脉介入治疗对肺结核空洞的治疗效果。方法肺结核空洞患者109例,随机分为介入治疗组(55例)和对照组(54例);介入治疗组在数字减影血管造影(DSA)下,经Seldinger技术,在肺结核病变区灌注抗结核药物并行支气管动脉栓塞术;对照组作抗痨常规治疗。结果两组患者治疗后经2个月的随访,介入治疗组痰菌阴转率62.50%与对照组56.50%比较差异无统计学意义(χ2=0.004P>0.05);X线胸片示介入治疗组病灶吸收率83.63%,空洞关闭和缩小率70.91%,均高于对照组(64.81%、38.89%),两组相比差异有统计学意义(χ2=9.44、21.4,均P<0.01);介入治疗对薄壁空洞+厚壁空洞患者的空洞缩小率(92.65%)与纤维厚壁空洞+硬壁空洞者空洞缩小率(41.67%)相比差异有统计学意义(χ2=24.13P<0.01);介入治疗组薄壁空洞、厚壁空洞、纤维厚壁空洞的空洞缩小率(100.0%、75.70%、41.67%)优于对照组(χ2=8.57、5.20、5.39P<0.01P<0.05P<0.05)。结论支气管动脉介入治疗肺结核空洞有效安全。
Objective To evaluate the clinical value of interventional therapy via bronchial artery in treatment of pulmonary tuberculosis cavities. Methods 109 patients with pulmonary tuberculosis cavities were randomized to interventional therapy grorp(55 cases) and control group(54 cases).Aided by digital subtraction amgiography(DSA), anti-tuberculsis drugs infusion via bronchial artery and embolization were performed on the patients in intervention grorp by Seldinger’s method. Traditional anti-tuberculsis therapy were performed on the patients in comtrol group. Results At the end of 2 months,no significant difference was found in the sputum negative conversion between the 2 groups(χ2=0.004 P>0.05). the focal absorptivity and the cavity closing or shrinking rate were 83.63% and 70.91% respectively in the intervention group, which were higher than in the control group(64.81% and 38.89% respectively) (χ2=9.44,21.4; P<0.01). No complication or obvious adverse reactions were observed. The effect of the interventional therapy on the thick-wall cavities and thin - wall cavities was better than on the fobrotic thick-wall cavities and hard-wall cavities(χ2=24.13, P<0.01). The effect of the interventional therapy on the thick-wall cavities,thin-wall cavities and fobrotic thick-wall cavities was better than the traditional anti-tuberculsis therapy(χ2=8.57,5.20,5.39; P<0.01, P<0.05, P<0.05). Conclusion The interventional therapy via bronchial artery was effective and safe in treatment of pulmonary tuberculosis cavities.
出处
《浙江医学》
CAS
2007年第2期126-127,185,共3页
Zhejiang Medical Journal
关键词
结核
肺
栓塞治疗
SELDINGER技术
Tuberculosis lung Cavitary intervetional therapy Technigue seldinger
