经纤维支气管镜激光治疗耐多药支气管内膜结核

目的评价经纤维支气管镜局部Nd：YAG激光照射治疗耐多药支气管结核的疗效。方法耐多药支气管内膜结核91例。对照组45例,以全身抗结核与雾化治疗;治疗组46例,除上述治疗,另以功率为30～40 W,光斑直径1 mm,脉冲时间4～6 s,照射时间80～120 s的Nd：YAG激光．由石英纤维经支气管镜导入,烧灼病灶。治疗后随访18个月,比较两种疗法的疗效。结果经过平均3．8个月的临床治疗,治疗组46例患者全部痰菌阴转,41例患者的支气管结核病灶吸收好转;对照组45例患者中仅38例患者痰菌阴转,39例患者痰结核菌培养阴转,31例支气管结核病灶吸收好转。结论在全身用药及雾化治疗的基础上,经纤维支气管镜局部激光照射治疗耐多药支气管结核,疗效可靠,操作相对简单、安全,是一种对耐多药支气管结核治疗的有效方法。

Using Nd:YAG Laser via Fibrobronchoscopy to Treat Multi-drug-Resistant Endotracheobronchial Tuberculosis

Objective To explore the efficacy of using the Nd: YAG laser via fibrobronchoscopy to treat the multi-drug-resistant endotracheobron-chial tuberculosis. Methods Forty-six patients with multi-drug-resistant endotracheobronchial tuberculosis were treated with the Nd: YAG laser and ultrasonic atomizing in addition to chemotherapy, while forty-five patients as the controls were treated with ultrasonic atomizing and chemotherapy. Results At the end of the average 3. Smonths after the treatment, the sputum negative rate was 100. 0% , the radiographic recovery rate was 97. 83% and the focus absorption rate was 89. 13% in the treatment group, all of that were superior to the controls; the severe cicatrical stenosis rate in treatment group and control group during follow-up were 10. 86% and 24. 44% .respectively; no complication and obvious adverse reaction were observed. Conclusions Treating multi-drug-resistant endotracheobronchial tuberculosis using the Nd: YAG laser via fibrobronchoscopy is safe, more simple and reproducible.