支气管结核的外科治疗  

Surgical Treatment of Bronchial Stricture due to Endobronchial Tuberculosis： Results in 36 Consecutive Cases

作　　者：阮军忠[1] 张天辉[1] 李福根[1] 段勇[1] 韩鸣[1] 王子彤[1] Ruan Junzhong, Zhang Tianhui, Li Fugen, Duan Yong, Han Ming, Wang Zitong(Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China)

机构地区：[1]首都医科大学附属北京胸科医院胸外科,北京101149

出　　处：《结核病与胸部肿瘤》2018年第3期190-193,共4页Tuberculosis and Thoracic Tumor

摘　　要：背景与目的支气管结核是肺结核常见的并发症，本研究目的是探讨支气管结核的临床特点，手术指征及总结外科治疗经验。方法对36例诊断明确且造成支气管狭窄或肺不张的支气管结核患者，给予药物及内镜腔内治疗无效而进行外科治疗，术前规律抗结核治疗6个月以上，术后继续抗结核治疗9个月，12个月。其中全肺切除8例，肺叶切除23例，袖状肺叶切除5例。结果36例患者均治愈，无手术死亡，6例患者术后出现并发症，给与对应治疗痊愈出院，无支气管胸膜瘘及结核播散。随访1年以上无复发。结论对于药物及内镜治疗无效，伴有肺内不可逆病变的支气管结核患者应考虑积极手术。Background and Objective Bronchial tuberculosis is a common complication of pulmonary tuberculosis. The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis, when the drug and endoscopic treatment were no effect. Methods Reviewed the cliniealpathological records docmnenting the surgical outcomes in 36 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 2000 and February 2016. Pneumonectomy in 8 cases, lobectomy in 23 cases, sleeve resection in 5 cases. Results No intraoperative or early postoperative death occurred. Six patients developed complications. All 6 cases recovered well after treatment. Conclusion Surgical treatment is still the recommended treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its good results. It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed.

关 键 词：支气管结核 支气管狭窄 外科治疗 

分 类 号：R523[医药卫生—内科学]