纤维支气管镜介入治疗肺结核的疗效观察  

Efficacy observation of fiberoptic bronchoscopy in the treatment of pulmonary tuberculosis

作　　者：冼宏 陈利霞 甘凤英 XIAN Hong;CHEN Li-xia;GAN Feng-ying(Department of Respiratory Medicine,Heyuan People's Hospital,Heyuan 517000,China)

机构地区：[1]河源市人民医院呼吸内科,517000

出　　处：《中国现代药物应用》2022年第9期33-36,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨纤维支气管镜介入治疗肺结核的临床疗效。方法90例肺结核患者,随机分为对照组和观察组,各45例。对照组使用常规抗结核治疗,观察组在对照组基础上应用纤维支气管镜介入治疗。比较两组临床疗效、痰菌转阴率及病灶好转率、不良反应发生情况及治疗前后T细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平。结果观察组治疗总有效率为88.89%,明显高于对照组的66.67%,差异具有统计学意义(P<0.05)。观察组治疗1、3、6个月痰菌转阴率、病灶好转率明显高于对照组,差异具有统计学意义(P<0.05)。治疗前,两组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05);治疗6个月,观察组CD4^(+)(46.45±5.02)%、CD4^(+)/CD8^(+)(2.16±0.23)明显高于对照组的(36.97±4.76)%、(1.30±0.24),CD8^(+)(21.54±4.26)%明显低于对照组的(28.49±4.43)%,差异具有统计学意义(P<0.05)。观察组不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论应用纤维支气管镜介入治疗肺结核的疗效显著,能够提高痰菌转阴率和病灶好转率,调节机体免疫,且不良反应发生率较低,具有积极的临床意义。Objective To discuss the clinical efficacy of fiberoptic bronchoscopy in the treatment of pulmonary tuberculosis.Methods A total of 90 cases of pulmonary tuberculosis patients were randomly divided into control group and observation group,with 45 cases in each group.The control group was treated with conventional anti-tuberculosis therapy,while the observation group was treated with fiberoptic bronchoscopy on the basis of the control group.The clinical efficacy,sputum negative-conversion rate and focus improvement rate,occurrence of adverse reactions and T cell subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 88.89%,which was significantly higher than 66.67%of the control group,and the difference was statistically significant(P<0.05).The sputum negative-conversion rate and focus improvement rate in the observation group after 1,3 and 6 months of treatment were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in CD4^(+),CD8^(+),CD4^(+)/CD8^(+)between the two groups(P>0.05).After 6 months of treatment,the CD4^(+)(46.45±5.02)%and CD4^(+)/CD8^(+)(2.16±0.23)in the observation group were significantly higher than(36.97±4.76)%and(1.30±0.24)in the control group,and the CD8^(+)(21.54±4.26)%was significantly higher than(28.49±4.43)%in the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion The application of fiberoptic bronchoscopy has a significant effect in the treatment of pulmonary tuberculosis.It can increase the sputum negative-conversion rate and focus improvement rate,and regulate the body's immunity.The incidence of adverse reactions is low,and has a positive clinical significance.

关 键 词：肺结核 纤维支气管镜介入 异烟肼 利福平 吡嗪酰胺 乙胺丁醇 

分 类 号：R521[医药卫生—内科学]