纤维支气管镜下钳夹加注药治疗支气管结核223例疗效观察  

Efficacy observation of 223 cases with endobronchial tuberculosis treated by forceps clip and drug infusion via fiber bronchoscopy

作　　者：林霏申[1] 陈珊珊[1] 于俊[1] 杜前锋[1] 张侠[1] 

机构地区：[1]南京胸科医院结核科,江苏南京210029

出　　处：《临床肺科杂志》2011年第8期1219-1220,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察及分析纤维支气管镜下钳夹加注药治疗支气管结核(溃疡及干酪坏死型及肉芽增生型)的疗效。方法我科自2009年3月至2010年7月,共发现支气管结核(溃疡及干酪坏死型及肉芽增生型)223例。均采用HREZ方案全身抗结核治疗(根据药敏试验加或不加左氧氟沙星)。并予抗结核药物雾化吸入局部治疗,纤维支气管镜下钳夹坏死物及肉芽组织,并在病变支气管内注入抗结核药物。观察治疗后镜下表现的变化。结果本组223例患者,全吸23例(占10.31%),显效96例(占43.05%),有效101例(占45.29%),不变3例(占1.35%),无恶化病例。总有效率98.65%,而无效率仅为1.35%。结论纤支镜下钳夹加注药治疗支气管结核疗效确切、并发症少、对避免形成气道瘢痕、狭窄、肺不张等后遗症有着良好的效果。Objective To observe and analyze the efficacy of interventional therapy via fiber bronchoscopy in the trcatment of endobronchial tuberculosis（necrotic ulcer and granulation）.Methods 223 cases with endobronchial tuberculosis（necrotic ulcer and granulation） were examined by fiber bronchoscopy from March 2009 to July 2010 in our department.We treated them with chemotherapy（HREZ/V） and aerosol inhalation of anti-tuberculosis drugs.Also we clipped necrostic and granulation tissue,then infused anti-tuberculosis drugs in lesions.The changes of the bronchoscopic features were analyzed.Results Among 223 patients,23 patients had total absorption（10.31%）,119 examples had significant effect（43.05%）,101 had effectiveness（45.29%）,and while 3 cases had no effect（1.35%）.The total effective rate was 98.65% and the invalid rate was merely 1.35%.Conclusion The fiber bronchoscopic therapy had definite effect with less complications.It could effectively avoid airway scar formation,stenosis,atelectasis and other complications.

关 键 词：纤维支气管镜 支气管结核 介入治疗 

分 类 号：R521.2[医药卫生—内科学]