无痛电子支气管镜介入结合局部化疗治疗痰菌阳性支气管结核的近期及远期疗效
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摘要
目的探讨无痛电子支气管镜介入结合局部化疗治疗痰菌阳性支气管结核的近期及远期疗效。方法选取2016年1月至2018年1月痰菌阳性支气管结核患者84例,依据治疗方案将其分为对照组与治疗组,每组42例。对照组采用全身抗结核治疗,治疗组在此基础上,加用无痛电子支气管镜介入(冷冻、钳夹、球囊扩张)治疗,及局部(INH 0.2 g+AM 0.4 g雾化)化疗。比较两组患者近期及远期临床症状改善率、肺部影像改变率、抗酸杆菌转阴率、抗酸杆菌耐药发生率及支气管狭窄发生率。结果治疗组患者近期临床症状改善率为59.52%,肺部影像改变率为57.14%,抗酸杆菌转阴率为54.76%,抗酸杆菌耐药发生率为14.29%,支气管狭窄发生率为23.81%;治疗组远期相应值分别为95.24%、92.86%、95.24%、2.38%、7.14%。治疗组近期及远期临床症状改善率、肺部影像改变率、抗酸杆菌转阴率高于对照组(P<0.05),抗酸杆菌耐药、支气管狭窄发生率低于对照组(P<0.05)。结论在正规抗结核化疗基础上加用无痛电子支气管镜介入治疗,可改善近远期临床症状,减少气道狭窄、闭塞、肺不张等不良事件,有效提高患者的生活质量。
Objective To investigate short-term the and long-term effects of painless electron bronchoscopy combined with local chemotherapy on sputum positive bronchial tuberculosis.Methods Eighty-four patients with sputum positive bronchial tuberculosis were selected and divided into control group and treatment group from January 2016 to January 2018,according to treatment plan,with42 cases in each group.The control group was given systemic anti-TB treatment,the treatment group was treated with painless electronic bronchoscopy(freezing,clamping,balloon dilation) on this basis,and local(spraying inh 0.2 g + AM 0.4 g) chemotherapy.The short-term and long-term clinical symptom improvement rate,pulmonary image change rate,anti-acid bacillus transfection rate,the incidence of anti-acid bacillus resistance and the incidence of bronchial stenosis were compared between the two groups.Results In the treatment group,the improvement rate of clinical symptoms was 59.52%,the rate of lung image change was 57.14%,the rate of anti-acid bacillus was 54.76%,the incidence of drug resistance was 14.29%,the incidence of bronchial stenosis was 23.81%,and the corresponding values of the treatment group were 95.24%,92.86%,95.24%,2.38%,7.14%.In the treatment group,the rate of improvement of clinical symptoms,the rate of change of lung image and the rate of acid-resistand bacillus were higher than that in the control group(P<0.05),and the incidence of anti-acid bacillus resistance and bronchial stenosis was lower than that in the control group(P<0.05).Conclusions The addition of painless electronic bronchoscopy to interventional therapy on the basis of regular anti-TB chemotherapy can improve the short-term and long-term clinical symptoms,reduce airway stenosis,occlusion,atelectasis and other adverse events,and effectively improve the quality of life of patients.
Objective To investigate short-term the and long-term effects of painless electron bronchoscopy combined with local chemotherapy on sputum positive bronchial tuberculosis.Methods Eighty-four patients with sputum positive bronchial tuberculosis were selected and divided into control group and treatment group from January 2016 to January 2018,according to treatment plan,with42 cases in each group.The control group was given systemic anti-TB treatment,the treatment group was treated with painless electronic bronchoscopy(freezing,clamping,balloon dilation) on this basis,and local(spraying inh 0.2 g + AM 0.4 g) chemotherapy.The short-term and long-term clinical symptom improvement rate,pulmonary image change rate,anti-acid bacillus transfection rate,the incidence of anti-acid bacillus resistance and the incidence of bronchial stenosis were compared between the two groups.Results In the treatment group,the improvement rate of clinical symptoms was 59.52%,the rate of lung image change was 57.14%,the rate of anti-acid bacillus was 54.76%,the incidence of drug resistance was 14.29%,the incidence of bronchial stenosis was 23.81%,and the corresponding values of the treatment group were 95.24%,92.86%,95.24%,2.38%,7.14%.In the treatment group,the rate of improvement of clinical symptoms,the rate of change of lung image and the rate of acid-resistand bacillus were higher than that in the control group(P<0.05),and the incidence of anti-acid bacillus resistance and bronchial stenosis was lower than that in the control group(P<0.05).Conclusions The addition of painless electronic bronchoscopy to interventional therapy on the basis of regular anti-TB chemotherapy can improve the short-term and long-term clinical symptoms,reduce airway stenosis,occlusion,atelectasis and other adverse events,and effectively improve the quality of life of patients.
引文
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[4]于丹.支气管镜介入冷冻治疗支气管结核临床研究[J].中国现代医生,2016,54(8):82-84.
[5]龙云铸,刘毅,刘双柏,等.气管支气管结核患者经电子支气管镜介入治疗的近期与远期疗效观察[J].新疆医科大学学报,2016,39(6):735-738.DOI:10.3969/j.issn.1009-5551.2016.06.017.
[6]温明超,周玲,杨莹,等.支气管镜介入辅助治疗气管支气管结核的价值[J].临床肺科杂志,2016,21(7):1282-1285.DOI:10.3969/j.issn.1009-6663.2016.07.035.