长疗程抗生素联合雾化吸入在良性气管狭窄呼吸内镜治疗中的作用  

Effect of long-term antibiotics combined with inhalation therapy in treatment of benign tracheal stenosis after bronchoscopic interventional therapy

作　　者：徐明鹏 李莉华[1] 黎雨[1] 梁毅林 甘罗曼 柳广南[1] 

机构地区：[1]广西医科大学第二附属医院呼吸内科,广西南宁530007 [2]百色迎龙医院呼吸内科,广西百色533000 [3]青海大学医学院,青海西宁810016

出　　处：《临床荟萃》2017年第4期327-330,335,共5页Clinical Focus

摘　　要：目的探讨呼吸内镜介入治疗后,长疗程静脉用抗生素联合雾化吸入治疗良性气管狭窄的长期疗效。方法回顾性分析因不同病因致良性气管狭窄,并经呼吸内镜介入治疗术后,抗生素治疗时间≥1个月,同时雾化吸入阿米卡星和布地奈德悬液治疗6个月的67例患者的临床资料。测量呼吸内镜介入治疗术前后狭窄段气管的内径、气促评分;评价近期及6个月后治疗效果和并发症的发生情况。结果呼吸内镜介入治疗后,狭窄段气管内径由(3.82±0.91)mm增加到(12.16±1.57)mm;气促指数由(3.45±0.63)降低到(0.52±0.50),差异均有统计学意义(P<0.05),术后近期治疗疗效为100%;经静脉用抗生素治疗1个月,同时雾化吸入阿米卡星和布地奈德悬液6个月内的气管通畅率94.02%。二重感染等并发症均未出现。结论良性气管狭窄呼吸内镜介入术后长疗程静脉用抗生素联合雾化吸入治疗可提高长期疗效。Objective To evaluate the efficacy of long-term antibiotics combined with inhalation therapy in the treatment of patients with benign tracheal stenosis after bronchoscopic interventional therapy.Methods Retrospective analysis was performed in the clinical data of 67 cases of benign tracheal stenosis treated with long-term antibiotics（more than 1 month）combined with inhalation of budesonide and amikacin for six months after bronchoscopic interventional therapy.The tracheal diameter and dyspnea index were evaluated before and after bronchoscopic interventional therapy.And initial cure rate and cure rate after six months and complications were evaluated.ResultsAfter bronchoscopic interventional therapy,the tracheal diameter significantly increased from（3.82±0.91）mm to（12.16±1.57）mm（P〈0.05）,and the dyspnea index significantly decreased from（3.45±0.63）to（0.52±0.50）（P〈0.05）.After bronchoscopic interventional therapy,the initial cure rate was 100%.After intravenous antibiotic therapy for one month,combined with inhalation of amikacin and budesonide suspension for six months,the unblocked rate of tracheal was 94.02%.No complications such as double infection happened.Conclusion After the bronchoscopic interventional therapy,long-term intravenous antibiotic therapy combined with inhalation therapy in benign tracheal stenosis can improve long-term efficacy.

关 键 词：气管狭窄 支气管镜检查 抗菌药 

分 类 号：R562.12[医药卫生—呼吸系统]