支气管镜局部注射化疗在支气管结核患者治疗中的应用  

Application of local injection chemotherapy of bronchoscopy in treatment of patients with bronchial tuberculosis

作　　者：李庆伟[1] 孔祥臣[1] 刘莹[1] 张会娟[1] LI Qing-wei;KONG Xiang-chen;LIU Ying;ZHANG Hui-juan(Department of Respiratory Medicine,the Central Hospital of Jiaozuo Coal Industry,Jiaozuo,Henan　454150,China)

机构地区：[1]焦作煤业集团中央医院呼吸2科,河南焦作454150

出　　处：《临床肺科杂志》2018年第5期929-933,共5页Journal of Clinical Pulmonary Medicine

基　　金：河南省卫生厅科研项目(No 14AH062174)

摘　　要：目的分析支气管镜局部注射化疗在支气管结核患者治疗中的应用价值。方法选取我院2011年8月至2016年7月收治的支气管结核患者90例为研究对象,根据治疗方法不同分为实验组(n=45)和对照组(n=45),对照组患者给予支气管结核常规2RHZE/10RHE化疗方案,实验组患者在对照组化疗基础上进行经支气管镜局部注射辅助治疗,均连续治疗4周。观察两组痰菌转阴情况、浸润病灶吸收效果,进行特异性指标检测,并评估治疗的安全性。结果实验组治疗后3个月、6个月、12个月痰菌转阴率为44.44%、75.56%、93.33%明显高于对照组的26.67%、53.33%、77.78%(P<0.05)。实验组浸润病灶吸收率84.44%明显高于对照组的64.44%(P<0.05),且两组浸润病灶吸收效果分布比较差异有统计学意义(P<0.05)。两组治疗前血清、支气管肺泡灌洗液中腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)浓度比较无统计学意义(P>0.05),治疗后血清、支气管肺泡灌洗液中ADA、LDH浓度均显著下降(P<0.05),且实验组治疗后血清、支气管肺泡灌洗液中ADA、LDH浓度均显著低于对照组(P<0.05)。两组不良反应均较轻微,发生率均较低,比较无统计学意义(P>0.05)。结论应用支气管镜局部注射治疗支气管结核,可明显提高患者痰菌阴转率,促进病灶吸收,且安全性高。Objective To analyze the application value of local injection chemotherapy of bronchoscopy in treatment of patients with bronchial tuberculosis.Methods 90 bronchial tuberculosis patients from August 2011 to July 2016 were retrospectively selected for the study and divided into the experimental group(n=45)and the control group(n=45)according to the different treatment methods.The control group was treated with bronchial tuberculosis conventional 2RHZE/10RHE chemotherapy regimen,and the experimental group was given bronchoscopic local injection adjuvant therapy on the basis of treatment in the control group,and the two groups were treated continuously for 4 weeks.The sputum negative condition and the absorption effect of infiltrative focus were observed between the two groups,and the specificity index was detected and the safety of treatment was evaluated.Results The sputum negative rate was 44.44%,75.56%and 93.33%respectively at 3 months,6 months and 12 months after treatment in the experimental group,which were significantly higher than those in the control group with 26.67%,53.33%and 77.78%respectively(P<0.05).The absorption rate of infiltrative focus was 84.44%in the experimental group and 64.44%in the control group(P<0.05).There was no significant difference in the concentrations of adenosine deaminase(ADA)and lactate dehydrogenase(LDH)in serum and bronchoalveolar lavage fluid of the two groups before treatment(P>0.05),and after treatment,the concentrations of ADA and LDH in the serum and bronchoalveolar lavage fluid were significantly decreased(P<0.05),and the concentrations of ADA and LDH in serum and bronchoalveolar lavage fluid were significantly lower in the experimental group than those in the control group(P<0.05).The adverse reactions were mild and the incidence was low,which was not statistically significant between the two groups(P>0.05).Conclusion The application of bronchoscopic local injection chemotherapy can significantly improve the sputum negative rate of patients and promote the lesions absor

关 键 词：支气管镜 局部注射 化疗 支气管结核 

分 类 号：R521.1[医药卫生—内科学]