纤维支气管镜下微波联合药物治疗肺部曲菌球病的临床研究  

Clinical research of microwave therapy conbined medicine therapy by fiberoptic bronchoscopy in treating pulmonary aspergillosis

作　　者：车春利[1] 霍建民[1] 桑玉兰[1] 

机构地区：[1]哈尔滨医科大学第一临床学院呼吸内科,黑龙江哈尔滨150010

出　　处：《中国内镜杂志》2006年第6期611-613,共3页China Journal of Endoscopy

摘　　要：目的探讨经纤维支气管镜应用微波技术联合抗真菌药物局部治疗肺曲菌球的疗效及安全性。方法28例患者局麻后,鼻腔插入纤支镜达病变部位,经活检孔导入微波电极,对病灶进行电凝治疗,使病灶发生凝固性坏死。出血灶给予电凝止血。经给药孔局部注入依曲康唑200mg,每周1、2次,疗程5、6次。结果疗程结束后,治愈率86.05%,有效率98.95%。随访12个月后,因原基础疾病出现咯血4例。所有病例均无复发。不良反应及并发症为气胸8.33%、肺不张4.17%、出血8.33%、喉痉挛4.17%、灼伤4.17%。无肝肾功能损害、粒细胞减少、低血钾。结论经纤支镜微波联合抗真菌药物对肺曲菌球病的治疗,是一种疗效确切、方法简单、安全有效的治疗手段。[Objective] To explore the curative effect and the safety of microwave technique conbined anitifungal drug by fiberoptic bronchoscopy in local treating pulmonary aspergillosis. [Methods] After local anesthesia, 28 patients were inserted fiberoptlc bronchoscopy from the nasal cavity to pathological changes part. Dueting into the microwave electrode through the bore of biopsy, cured the nidus with electrocoagulation that they turned into coagulation necrosis. Where bleeding was treated with electrocoagulation. Location was injected Itraconazole 200 mg through the bore of administration, 1～2 times every week, period of treatment 5～6 times. [Results] After period of treatment ending, curative rate 86.05%, effective rate 98.95%. After followed up 12 months, there are 4 cases appearing hemoplysis because of foundation disease, but all cases don＇t relapse. Bad respond and complications are ： Pneumothorax 8.33%, Atelectasis 4.17%, Bleeding 8.33%, Laryngismus 4.17%, Burning 4.17%. Without hepatic or renal dysfunction, leukopenia, hypokalmia. [Conclusions] The microwave conbined medicine therapy by fiberoptic bronchoscopy in treating pulmonary aspergillosis is, with definite curative effect and simple method, a safe and effective therapeutic means.

关 键 词：纤维支气管镜 微波 依曲康唑 肺部疾病 曲菌球病 

分 类 号：R563[医药卫生—呼吸系统]