冷冻联合低温等离子治疗淋巴结瘘型气管支气管结核的临床研究  

Clinical research of plasma radio-frequency ablation at low temperature combined with cryotherapy on tracheobronchial tuberculosis of lymphatic fistula type

作　　者：郭朝蕾 李雨辰 阮超 段春宇 丁超 GUO Zhao-lei;LI Yu-chen;RUAN Chao;DUAN Chun-yu;DING Chao(Endoscopic Center,Xi′an Chest Hospital,Xi′an,Shaanxi 710100,China)

机构地区：[1]西安市胸科医院内镜中心,陕西西安710100

出　　处：《临床肺科杂志》2022年第12期1811-1816,共6页Journal of Clinical Pulmonary Medicine

基　　金：西安市卫健委内部资助课题(No.22J201702022)。

摘　　要：目的探讨低温等离子射频消融技术联合冷冻治疗淋巴结瘘型支气管结核的效果、优势及安全性。方法收治中心气道支气管淋巴结瘘处于破溃期的患者64例,随机分为两组,对照组应用冷冻取坏死物及局部给药治疗,实验组在对照组治疗基础上加用低温等离子消融术治疗。比较两组患者镜下治疗的次数、平均镜下治疗时间、瘘口愈合周期、结核菌的病原学检查阴转时间及术中术后并发症的情况。结果实验组和对照组在年龄(P=0.759)、性别(P=0.599)、瘘口个数(P=0.254)等基线资料方面无明显的差异。两组患者镜下治疗的次数(P=0.239)及并发症(P=0.390)方面无明显差异。实验组在瘘口愈合周期(P=0.017),结核菌病原学检查阴转时间(P=0.024),平均镜下治疗时间(P=0.025)方面优于对照组。结论冷冻联合低温等离子消融术对于破溃期淋巴结瘘型支气管结核的治疗安全可行,提高了镜下治疗的效率。Objective To explore the effect,advantage,and safety of plasma radio-frequency ablation at low temperature technology combined with cryotherapy on tracheobronchial tuberculosis of lymphatic fistula type.Methods A total of 64 cases with lymph node fistula located in the central airway at the stage of rupture were randomly divided into two groups.The control group was treated with cryotherapy and local anti-TB drugs delivery,and the experimental group was treated with low-temperature plasma ablation on the basis of the control group.The times of fistula healing cycle,the average treatment time of surgery,the time of negative transition of mycobacterium tuberculosis,the intraoperative and postoperative complications were compared between the two groups.Results There was no significant difference between the two groups in terms of age(P=0.759),gender(P=0.599),number of fistulas(P=0.254),the frequency of endoscopic treatment(P=0.239)and complications(P=0.390).The fistula healing cycle(P=0.017),mycobacterium tuberculosis etiology negative transformation(P=0.024)and average treatment time of surgery(P=0.025)were better in the experimental group than in the control group.Conclusion The application of low-temperature plasma radio-frequency ablation is safe and feasible for lymph fistula type of bronchial tuberculosis at the stage of ulceration,and the modality improve the efficiency of the treatment and the clinical curative effect.

关 键 词：淋巴结瘘型气管支气管结核 支气管镜治疗 低温等离子消融术 

分 类 号：R523[医药卫生—内科学]