经支气管镜介入治疗溃疡坏死型支气管结核的疗效观察

目的探讨经支气管镜介入治疗溃疡坏死型支气管结核的临床效果。方法对我院2011年1月至9月经支气管镜检查确诊的63例溃疡坏死型支气管结核患者随机分为治疗组和对照组。两组均采用正规抗结核治疗HRZELv。对照组24例;治疗组39例在常规化疗的基础上,第一个月每周1次经支气管镜介入局部酌情给予APC、冷冻等治疗共四次,第二个月二周复查一次,并根据当时支气管镜下表现给予相应的处理。之后1～3个月复查一次,观察6个月。结果治疗6个月后痰菌转阴率对照组和治疗组分别为54.2%和87.2%;影像学检查显示病灶吸收率对照组和治疗组分别为58.3%和89.7%;支气管镜检查显示治疗有效率对照组和治疗组分别为62.5%和87.2%,两组差异均有显著性(P<0.05)。结论对溃疡坏死型支气管结核经支气管镜介入治疗联合抗结核化疗优于单纯抗结核化疗,值得临床推广应用。

Observation on the Therapeutic Effect of Interventional Technology therapy with chemotherapy of endobronchial tuberculosis

Objective To observe and evaluate the clinical curative effect of interventional therapy with flexible bronchoscope combined with chemotherapy for caseous endobronchial tuberculosis.Methods 63 cases have been selected from January to September of 2009 in our hospital,and divided into treated group,treated by interventional therapy with flexible bronchoscope combined with chemotherapy of tuberculosis,and control group,treated with chemotherapy of tuberculosis.Results After six months,the sputum negative conversion rates,the lesions absorption rates by X ray of detection,and the recovery rates observed by bronchoscopy were 87.2%,89.7% and 87.2% respectively for treated group,and 54.2%,58.3%,and 62.5% respectively for control group,all significantly higher than those in control group,(P<0.05).Conclusions The clinical curative effect of interventional therapy with flexible bronchoscope combined with chemotherapy is superior to single chemotherapy for caseous endobronchial tuberculosis,thus the combined treatment is recommended.