经纤维支气管镜综合治疗247例支气管内膜结核疗效分析  

Analysis on therapeutic effect of 247 cases of endobronchial tuberculosis treated with comprehensive methods through fiberbronchoscope

作　　者：贾育红[1] 王宁[1] 

机构地区：[1]河南省胸科医院,河南郑州450003

出　　处：《中国感染控制杂志》2007年第6期380-383,共4页Chinese Journal of Infection Control

摘　　要：目的探讨在全身抗结核基础上经纤维支气管镜(纤支镜)以微波为主要手段综合治疗支气管内膜结核(EBTB)的临床效果。方法将426例EBTB患者随机分为治疗组(247例)和对照组(179例)。治疗组在常规全身治疗的同时,重点经纤支镜进行微波热凝、黏膜下多点注药、凝胶注药等综合治疗;对照组仅常规进行全身抗结核治疗。追踪观察两组患者的临床疗效并进行对比分析。结果治疗2个月后,治疗组总有效率、治愈率、好转率分别为100.00%(247/247)、87.04%(215/247)、12.96%(32/247),对照组分别为74.86%(134/179)、54.19%(97/179)、20.67%(37/179),治疗组治愈率显著高于对照组(χ2=57.16,P<0.01);治疗组复发率为10.12%(25/247),对照组为47.76%(64/134),两组复发率差异有显著性(χ2=68.74,P<0.01)。结论经纤支镜综合应用微波等方法治疗EBTB疗效确切,痰菌转阴快,局部瘢痕形成少,复发率低,患者易接受。Objective To study the therapeutic effect of endobronchial tuberculosis （EBTB） with comprehensive methods through fiberbronchoscope on the basis of routine chemotherapy. Methods Four hundred and twenty-six EBTB patients were divided randomly into treatment group （ 247 cases ） and control group （179 cases）. The treatment group were given routine chemotherapy combined with microwave thermo-coagulation, injecting medicine into submucous layer in multiple points and iniecting antituberculotic with gel through fiberbronchoscope, the control group were only given routine general antituberculotic treatment, therapeutic effect between two groups were compared and analysed. Results After 2 months treatment,the total effective rate, the curing rate and improvement rate in treatment group was 100. 00% （247/247）, 87. 04%（215/247） and 12. 960/00（32/247） respectively, and in control group was 74. 86% （134/179）, 54. 19%（97/179） and 20. 67%（37/179） respectively. The curing rate of treatment group was obviously higher than that of control group （χ^2= 57. 16, P〈0. 01） ;the recurrent rate in treatment group and control group was 10. 12% （25/247） and 47.76%（64/134） respectively, there was significant difference in the recurrent rate betweefi the two groups （χ^2= 68. 74, P〈0. 01 ）. Conclusion The curative effect of comprehensive treatment on EBTB through fiberbronchoscope is definite, the sputum negative conversion is quick, scar and recurrence is little.

关 键 词：支气管结核 结核 抗结核治疗 微波 凝胶 

分 类 号：R523[医药卫生—内科学]