支气管镜下冷冻联合镜下给药治疗溃疡型支气管结核的临床效果  

Therapeutic effect of bronchoscope cryotherapy combined with endoscopic drug injection in the treatment of ulcerative bronchial tuberculosis

作　　者：刘扬 葛晓飞 陈宇飞 李瑞 LIU Yang;GE Xiaofei;CHEN Yufei;LI Rui(Department of Tuberculosis,Dalian Public Health Clinical Center,Dalian,Liaoning 116044,China;不详)

机构地区：[1]大连市公共卫生临床中心结核科,辽宁116000

出　　处：《中国微生态学杂志》2023年第9期1061-1065,共5页Chinese Journal of Microecology

摘　　要：目的探讨支气管镜下冷冻联合局部镜下注药对溃疡型支气管结核的临床效果,为该病的治疗提供参考。方法选取2019年1月至2021年1月大连市公共卫生临床中心结核科收治的溃疡坏死型支气管结核患者80例,根据治疗方案分为对照组(n=40,给予常规规范抗结核治疗)和研究组(n=40,在对照组基础上给予支气管镜下冷冻联合局部注药治疗)。观察两组患者治疗4周后疗效、痰菌转阴时间及治疗前和治疗4周后第1秒用力呼气量(FEV1)、白细胞介素-10(IL-10)、C反应蛋白(CRP)、血沉(ESR)水平及治疗期间不良反应情况。结果研究组患者总有效率高于对照组,痰菌转阴时间短于对照组(均P<0.05),但两组患者不良反应发生率比较差异无统计学意义(15.0%vs 12.5%,P>0.05)。两组患者治疗后FEV1水平较治疗前上升,IL-10、CRP、ESR水平较治疗前下降,研究组患者上述指标水平治疗前后差值大于对照组(均P<0.05)。结论支气管镜下冷冻联合局部镜下注药对溃疡型支气管结核的疗效较好,可抑制机体炎症介质的释放,缩短痰菌转阴时间,安全性较高。Objective To explore the efficacy of bronchoscope cryotherapy(BC)combined with local endoscopic drug injection in the treatment of ulcerative bronchial tuberculosis(BT),and provide a reference for the treatment.Methods A total of 80 patients with ulcerative necrotizing type of BT treated in the Dalian Public Health Clinical Center from January 2019 to January 2021 were divided into two groups according to the treatment plan.The control group(n=40)was given conventional standard anti-tuberculosis treatment,while the observation group(n=40)was treated with BC combined with local injection on the basis of the treatment given to control group.The efficacy,time to negative sputum culture,forced expiratory volume(FEV1),Interleukin-10(IL-10),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and adverse reactions were observed before and after treatment.Results The total efficiency rate in the observation group was higher,and the time to negative sputum culture was shorter than in the control group respectively(all P<0.05),but there was no significant difference in the incidence of adverse reactions between the two groups(15.0%vs 12.5%,P>0.05).FEV1 increased and IL-10,CRP and ESR decreased in the two groups after treatment(all P<0.05).The differences in the above indexes in the observation group before and after treatment were higher than those in the control group(all P<0.05).Conclusion The cryotherapy of BC under bronchoscope combined with local endoscopic drug injection is effective in the treatment of ulcerative BT,which can inhibit the release of inflammatory factors and shorten the time to negative sputum culture with good safety.

关 键 词：支气管结核 支气管镜 溃疡型 C反应蛋白 冷冻治疗 

分 类 号：R521.2[医药卫生—内科学]