摘要
目的探讨经纤维支气管镜冷冻联合灌注化疗治疗肉芽增殖型支气管结核的疗效与安全性。方法纳入2008年4月至2010年4月入组患者45例,男性19例,女性36例,年龄6岁～48岁,平均26岁。全部患者经纤维支气管镜确诊为肉芽增殖型支气管结核,在常规抗结核治疗的同时,每周或每两周进行纤维支气管镜下冷冻治疗,并给予异烟肼0.2g局部灌注。治疗1～9次不等,平均2.8次。对患者冷冻治疗前后的管腔再通状况、临床症状、胸部X线片进行详细记录,并进行对比研究。结果治疗过程中除3例出血较多,1例无效外,无其他严重并发症,无手术死亡。气管及叶以上支气管管腔再通率达97.78%。临床症状明显改善,改善率为呼吸困难25/26(96.15%)、咳嗽咳痰39/42(92.86%)、咯血24/30(80.00%)、发热23/25(92.00%),患者生活质量提高,随访半年病情稳定。结论经纤维支气管镜下冷冻联合局部灌注治疗疗效确切,并发症少,可解除气道梗阻、促进病灶吸收、快速缓解临床症状、改善生活质量。
Objective To evaluate the clinical effect and security of the cryotherapy com- bined with drug for endobronchial tuberculosis of granulation hyperplasia type by fiberoptic broncho- scopy. Methods Forty-five patients were enrolled in this study from April 2008 to April 2010, including 19 male and 36 female. The average age was 26 years（ranged from 6 to 48 years old）. All 45 patients, on the basis of the conventional antituberculosis chemotherapy, received the cryotherapy combined with drug by fiberoptic bronchoscopy once 7-14 d. Cryotherapy was performed 138 times for all patients ,2.8 times per patient on average. The trachea or bronchus station, symptom such as dyspnea, hemoptysis, cough, fever were observed. Results The unblocked ratio of trachea and bronehea was 97.78%. All patients got satisfied improvement ratio of symptoms, 25/26（96.15% ） for dyspnea, 39/42 （ 92.86% ） for cough, 24/30 （ 80. 00% ） for bemoptysis and 23/25 （ 92.00% ） for fever. The Follow-up time was 6 months. There was no severe perioperative complications and mor- tality except for 3 cases of moderate exeduation. Conclusions The cryotherapy combined with drug for endobronchial tuberculosis of granulation hyperplasia type by fiberoptie bronchoseopy was easy to perform with minimal wound. Not only could it provide an effective and rapid control of symptoms caused by endobronehial tuberculosis of granulation hyperplasia type. it could also unobstructed bronchus promptly and improve patients quality of life.
出处
《中华肺部疾病杂志（电子版）》
CAS
2011年第3期26-28,共3页
Chinese Journal of Lung Diseases(Electronic Edition)
