支气管镜介入治疗淋巴结瘘型气管支气管结核  

Bronchoscopic interventional therapy for lymph nodes fistula type tracheobronchial tuberculosis

作　　者：梁丽丽[1] 张国龙 刘新[1] 马芸[3] LIANG Lili;ZHANG Guolong;LIU Xin;MA Yun(Henan Provincial Chest Hospital, Zhengzhou, Henan 450008,China)

机构地区：[1]河南省胸科医院,河南郑州450008 [2]河南省疾病预防控制中心,河南郑州450000 [3]河南省人民医院,河南郑州450000

出　　处：《中国热带医学》2018年第6期603-605,613,共4页China Tropical Medicine

基　　金：国际科技合作与交流重大专项(No.2014DFA30340);河南省重点科技攻关项目(No.152102310152);河南省医学科技攻关项目(No.201702292)

摘　　要：目的评价支气管镜介入治疗对气管支气管淋巴结瘘型结核的临床疗效。方法对2013年1月—2017年12月收治的112例经支气管镜确诊为气管支气管淋巴结瘘型结核患者的临床资料进行回顾性分析,其中男性52例,女性60例。根据痰、肺泡灌洗液或脓液结核菌培养及药敏结果分为敏感组52例(一线抗结核药物均敏感)和耐多药组60例(一线抗结核药物中同时对异烟肼和利福平耐药)。对比两组抗结核治疗联合气管镜介入治疗的次数、时间及疗效。结果 112例气管支气管淋巴结瘘型结核患者中处于破溃期的84例,处于破溃后期的28例,敏感组52例介入治疗中位次数为6.5(2~13)次,中位治疗时间49.5(14~119)天;耐多药60例介入治疗中位次数为13(5~25)次,中位治疗时间92.5(48~225)天。112例患者共211个瘘口,敏感组与耐多药组治疗2个月瘘口愈合数分别为:53(69.7%)和30(22.2%),治疗4个月瘘口愈合数分别为:76(100.0%)和96(71.1%),治疗6个月瘘口愈合数分别为:76(100.0%)和126(93.3%),两组总有效率100%。两组患者在介入治疗次数和治疗时间上差异有统计学意义(P<0.05)。结论支气管镜介入治疗淋巴结瘘型气管支气管结核安全、有效。Objective To evaluate the clinical effect of bronchoscopic interventional therapy for lymph nodes fistula type tracheobronchial tuberculosis. Methods The clinical data of 112 patients who have been diagnosed as lymph nodes fistula type tracheobronchial tuberculosis by bronchoscopy and have received bronchoscopic interventional therapy were retrospectively analyzed during the period from January 2013 to December 2017. There were 52 male patients and 60 female patients enrolled this study. According to the results of Mycobacterium tuberculosis culture of sputum, alveolar lavage fluid or pus, 112 patients were divided into two groups： the sensitive group （the first line anti-TB drugs were all sensitive） and the multi drug resistant group （resistance to Isoniazid and Rifampicin at the same time）. The frequency of interventional therapies and duration of the therapies were retrospectively analyzed. The efficacy of the therapies and the related complications were assessed. Results Totally 112 patients, 84 patients of lymph nodes fistula type tracheobronchial tuberculosis were in the period of rupture while 28 patients were in the later stage of rupture. The median frequency of interventional therapy was 6.5 （2-13） times in the sensitive group, and the median therapy duration was 49.5 （14-119） days in the sensitive group. The median frequency of 60 cases was 13 （5-25） times in multi drug resistant group, and the median therapy duration was 92.5 （48-225） days in multi drug resistant group. There were 211 fistula in 112 patients of lymph nodes fistula type tracheobronchial tuberculosis. The number of fistula healing were 53（69.7%） in the sensitive group while the number were 30（22.2%） in the multi drug resistant group after 2 months treatment. The number of fistula healing were 76（100.0%） in the sensitive group while the number were 96（71.1%） in the multi drug resistant group after 4 months treatment. The number of fistula healing were 76（100.0%） in the sensitive group while t

关 键 词：结核 淋巴结 支气管瘘 支气管镜 介入治疗 

分 类 号：R521[医药卫生—内科学]