支气管内膜结核的纤维支气管镜下微波治疗  

ENDOBRONCHIAL TUBERCULOSIS TREATED BY MICROWAVE UNDER FIBEROPTIC BRONCHOSCOPE

作　　者：张庆[1] 肖彪[1] 罗凤芝[1] 于伟华[1] 王亚秋[1] 张丽华[1] 尚春风 赵会权 刘畅 

机构地区：[1]沈阳市胸科医院内镜室,110044 [2]辽中县胸科医院,辽中110000

出　　处：《中国内镜杂志》2003年第4期15-17,共3页China Journal of Endoscopy

摘　　要：目的 :探讨应用纤维支气管镜 (纤支镜 )引导微波治疗气管 -支气管内膜结核的疗效。方法 :5 2例支气管内膜结核患者 ,Ⅱ型支气管内膜结核 (溃疡、干酪坏死型 ) 8例 ,Ⅲ型支气管内膜结核 (肉芽增殖型 ) 2 7例 ,Ⅱ型、Ⅲ型支气管内膜结核 (混合存在 ) 17例 ,按纤维支气管镜介入治疗常规准备并插镜 ,将微波导线探出镜端 2～3cm ,接触欲行微波治疗的病灶表面 ,调节微波功率为 45～ 6 0W ,时间为每次 3～ 6S ,共计 2 5～ 30min。结果 :5 2例患者治疗均取得成功 ,40例经 3～ 4次镜下微波治疗和镜下给药 ,病变得到治愈。 8例病变经 6～ 8次微波治疗和镜下给药 ,其中 4例病情较重治疗后仍狭窄 ,建议球囊扩张和支架置入。结论 :内镜下微波治疗支气管内膜结核 ,能使病灶迅速缩小、治愈 ;咳漱、呼吸困难、肺不张明显改善 ,避免部分患者最终手术治疗。Objective::To explore the effect of microwave through fiberoptic bronchoscopy in the management of trachea-bronchus intima tuberculosis.Methods: Fifty-two cases of bronchia intima tuberculosis. Eight cases of ulcer and caseous necrosis (Ⅱ type). Twenty-seven cases of granulatron proliferation (Ⅲ type). Seventeen case of both( Ⅱ and Ⅲ type).lnsert the bronchoscopy finished all necessany preparation in fiberoptic bronchoscopy interventional therapy, microwave guide line 2～3cm out of bronchoscopy contact the surface of the focus.Microwave power is 45～60w, one time is 3～6s, and continue 25～30min.Results: Fifty-two of cases alquined success. Forty cases need for 3～4 times.Eight cases need for 6～8 times.Four serious patients' bronchia has still construction and saccule dilatation and stent in plantation was available.Conclusions:Microwave through fiberoptic bronchoscopy in the management of intima tabereulosis may make the focus diminished and cured,cough?dyspnea and ate lectasis can be abated ,and it avoids some patients operation.

关 键 词：纤维支气管镜 微波 支气管内膜结核 

分 类 号：R523[医药卫生—内科学]