纤维支气管镜下局部注药治疗气管、支气管结核的疗效观察

目的　为探讨气管、支气管结核纤维支气管镜 (简称纤支镜)下注药加化疗的临床疗效。方法 对经纤支镜检查、痰找抗酸杆菌以及临床明确诊断的气管、支气管结核分为化疗加纤支镜下注药治疗组和单纯化疗组,观察两组疗效,以及镜下不同类型有效率比较。结果 治疗 2个月后纤支镜组的临床症状、胸部X线表现、痰菌阴转率以及纤支镜下改变与单纯化疗组比较有非常显著性差异及显著性差异 (P＜0.01,P＜0.05),治疗 6月后痰菌阴转率及纤支镜下改变纤支镜组与单纯化疗组比较有显著性差异 (P＜0.05),镜下分型以肉芽增殖型、溃疡坏死型纤支镜组优于单纯化疗组,支气管炎型和瘢痕狭窄型纤支镜组与单纯化疗组对比无显著性差异。结论 肉芽增殖型、溃疡坏死型气管、支气管结核可采取化疗加纤支镜下注药,该治疗方法不仅能迅速缓解病人临床症状,而且能促进病灶吸收,提高临床疗效。

Study on the effect of bronchofiberscope and catheter intervention in the treatment of endobronchial tuberculosis

Objective To determine the effect of bronchofiberscope and catheter intervention combined with chemotherapy in the treatment of endobronchial tuberculosis.Methods To divide the patients with endobronchial tuberculosis diagnosed by bronchoscope.Sputum smere and clinical manifestation into two groups.One group was treated by bronchofiberscope and catheter intervention combined with chemotherapy,the other was treated simply by chemotherapy.Results The improvement rate of clinical symptoms.Radiographic and bronchoscopic manifestations and bacilli negative convertion rate in combined therapy group were significantly higher than that in simple therapy group (P<0.01,P<0.05).And after 6 months' therapy,bronchoscopic improvement and negative convertion rate in the combined therapy group were significantly higher than that in simple therapy group (P<0.05).In granulomatous and ulcerative subtypes of tuberculosis,the efficacy rate in comlined therapy group was higher than in simple therapy group.But in exudative and cicatricial subtypes,there was no significant difference in two groups.Conclusion Bronchofiberscope and catheter intervention combined chemotherapy could be applied in granulomatous and ulcerative endobronchial tuberculosis,for the therapy could not only rapidly relieve clinical symptoms,but also auelerate lesion absorbtion and improve treatment effect.