支气管镜下高频电灼联合球囊扩张治疗结核炎性气道狭窄  

Bronchoscopic high frequency electrocoagulation combined with balloon dilatation in treating tubereulesis inflammatory airway constriction

作　　者：胡继华[1] 黄锦丽[2] 王桂秀[1] 曾丽萍[3] 

机构地区：[1]中山大学附属东华医院呼吸内科,广东东莞523110 [2]中山大学附属东华医院内镜室,广东东莞523110 [3]中山大学附属东华医院统计室,广东东莞523110

出　　处：《中国医师进修杂志》2011年第13期23-26,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨支气管镜下高频电灼联合球囊扩张治疗结核炎性气道狭窄的疗效和安全性.方法 根据内镜治疗方法的不同,将55例结核炎性气道狭窄患者分成球囊扩张组（球囊组,26例）和高频电灼联合球囊扩张组（联合组,29例）.两组患者每周接受内镜治疗1次,观察气道狭窄治疗有效率、需要治疗的次数,结核菌转阴时间以及术中和术后并发症;并于治疗结束后3个月复查纤维支气管镜,观察两组气道再狭窄率.结果 球囊组、联合组再通有效率分别为69.2%（18/26）、89.7%（26/29）,两组比较差异无统计学意义（P＞0.05）,达到再通有效的治疗次数分别为（3.5±1.3）、（1.5±1.1）次,两组比较差异有统计学意义（P＜0.01）,术后结核菌转阴时间分别为（23.3±3.6）、（13.2±2.3）d,两组比较差异有统计学意义（P＜0.01）.两组术中出血、严重缺氧、心律失常及气胸等发生率比较差异无统计学意义（P＞0.05）,术后3个月气管再狭窄率分别是33.3%（6/18）、7.7%（2/26）,两组比较差异有统计学意义（P＜0.05）.结论 支气管镜下高频电灼联合球囊扩张治疗结核炎性气道狭窄安全有效,并可减少介入治疗次数,缩短结核菌阴转时间,还有可能减少再狭窄率.Objective To explore the efficacy and safety of the bronchoscopic high frequency electrocoagulation combined with balloon dilatation in treating tuberculosis inflammatory airway constriction. Methods According to the different methods of treatment, 55 patients with tuberculosis airway constriction were randomly divided into two groups, the balloon dilatation group （26 cases） and combination group （29 cases）. The patients in balloon dilatation group underwent bronchoscopic balloon dilatation and the patients in combination group underwent bronchoscopic balloon dilatation combined with high frequency electrocoagulation. The patients of the two groups accepted endoscopic therapy once a week. Effective rate of recanalization for the narrow airway, frequency of effective treatment and the time of tuberculosis bacterium vanishing was recorded. Intraoperative and postoperative complications were also observed. Three months after the treatment, all patients accepted bronchoscopic to observe and assess the airway restenosis rate. Results After treatment, the effective rate in balloon dilatation group and combination group had no significant difference[69.2%（18/26） vs. 89.7% （26/29 ）]（P〉 0.05 ）,but frequency of effective treatment and time of tuberculosis bacterium vanishing had significant difference[（3.5 ±1.3） times vs. （1.5 ± 1.1） times, （23.3 ±3.6） d vs.（13.2 ±2.3） d]（P〈0.01）. There was no significant difference on the intraoperative and postoperative complications between two groups （P〉0.05）. The airway restenosis rate was 33.3%（6/18） in balloon dilatation group and 7.7%（2/26） in combination group after treatment for 3 months （P 〈0.05）. Conclusions Combination of bronchoscopic balloon dilatation and high frequency electrocoagulation is an efficacy and safety way for the tuberculosis inflammatory airway stenosis. It can reduce the frequency of interventional therapy, shorten the time of tuberculosis bacterium vanishing, and may also decrease the airway

关 键 词：电凝术 支气管镜 结核 气管狭窄 

分 类 号：R5[医药卫生—内科学]