中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
13期
23-26
,共4页
胡继华%黄锦丽%王桂秀%曾丽萍
鬍繼華%黃錦麗%王桂秀%曾麗萍
호계화%황금려%왕계수%증려평
电凝术%支气管镜%结核%气管狭窄
電凝術%支氣管鏡%結覈%氣管狹窄
전응술%지기관경%결핵%기관협착
Electrocoagulation%Bronchoscopes%Tuberculosis%Traoheal stenosis
目的 探讨支气管镜下高频电灼联合球囊扩张治疗结核炎性气道狭窄的疗效和安全性.方法 根据内镜治疗方法的不同,将55例结核炎性气道狭窄患者分成球囊扩张组(球囊组,26例)和高频电灼联合球囊扩张组(联合组,29例).两组患者每周接受内镜治疗1次,观察气道狭窄治疗有效率、需要治疗的次数,结核菌转阴时间以及术中和术后并发症;并于治疗结束后3个月复查纤维支气管镜,观察两组气道再狭窄率.结果 球囊组、联合组再通有效率分别为69.2%(18/26)、89.7%(26/29),两组比较差异无统计学意义(P＞0.05),达到再通有效的治疗次数分别为(3.5±1.3)、(1.5±1.1)次,两组比较差异有统计学意义(P＜0.01),术后结核菌转阴时间分别为(23.3±3.6)、(13.2±2.3)d,两组比较差异有统计学意义(P＜0.01).两组术中出血、严重缺氧、心律失常及气胸等发生率比较差异无统计学意义(P＞0.05),术后3个月气管再狭窄率分别是33.3%(6/18)、7.7%(2/26),两组比较差异有统计学意义(P＜0.05).结论 支气管镜下高频电灼联合球囊扩张治疗结核炎性气道狭窄安全有效,并可减少介入治疗次数,缩短结核菌阴转时间,还有可能减少再狭窄率.
目的 探討支氣管鏡下高頻電灼聯閤毬囊擴張治療結覈炎性氣道狹窄的療效和安全性.方法 根據內鏡治療方法的不同,將55例結覈炎性氣道狹窄患者分成毬囊擴張組(毬囊組,26例)和高頻電灼聯閤毬囊擴張組(聯閤組,29例).兩組患者每週接受內鏡治療1次,觀察氣道狹窄治療有效率、需要治療的次數,結覈菌轉陰時間以及術中和術後併髮癥;併于治療結束後3箇月複查纖維支氣管鏡,觀察兩組氣道再狹窄率.結果 毬囊組、聯閤組再通有效率分彆為69.2%(18/26)、89.7%(26/29),兩組比較差異無統計學意義(P＞0.05),達到再通有效的治療次數分彆為(3.5±1.3)、(1.5±1.1)次,兩組比較差異有統計學意義(P＜0.01),術後結覈菌轉陰時間分彆為(23.3±3.6)、(13.2±2.3)d,兩組比較差異有統計學意義(P＜0.01).兩組術中齣血、嚴重缺氧、心律失常及氣胸等髮生率比較差異無統計學意義(P＞0.05),術後3箇月氣管再狹窄率分彆是33.3%(6/18)、7.7%(2/26),兩組比較差異有統計學意義(P＜0.05).結論 支氣管鏡下高頻電灼聯閤毬囊擴張治療結覈炎性氣道狹窄安全有效,併可減少介入治療次數,縮短結覈菌陰轉時間,還有可能減少再狹窄率.
목적 탐토지기관경하고빈전작연합구낭확장치료결핵염성기도협착적료효화안전성.방법 근거내경치료방법적불동,장55례결핵염성기도협착환자분성구낭확장조(구낭조,26례)화고빈전작연합구낭확장조(연합조,29례).량조환자매주접수내경치료1차,관찰기도협착치료유효솔、수요치료적차수,결핵균전음시간이급술중화술후병발증;병우치료결속후3개월복사섬유지기관경,관찰량조기도재협착솔.결과 구낭조、연합조재통유효솔분별위69.2%(18/26)、89.7%(26/29),량조비교차이무통계학의의(P＞0.05),체도재통유효적치료차수분별위(3.5±1.3)、(1.5±1.1)차,량조비교차이유통계학의의(P＜0.01),술후결핵균전음시간분별위(23.3±3.6)、(13.2±2.3)d,량조비교차이유통계학의의(P＜0.01).량조술중출혈、엄중결양、심률실상급기흉등발생솔비교차이무통계학의의(P＞0.05),술후3개월기관재협착솔분별시33.3%(6/18)、7.7%(2/26),량조비교차이유통계학의의(P＜0.05).결론 지기관경하고빈전작연합구낭확장치료결핵염성기도협착안전유효,병가감소개입치료차수,축단결핵균음전시간,환유가능감소재협착솔.
Objective To explore the efficacy and safety of the bronchoscopic high frequency electrocoagulation combined with balloon dilatation in treating tuberculosis inflammatory airway constriction. Methods According to the different methods of treatment, 55 patients with tuberculosis airway constriction were randomly divided into two groups, the balloon dilatation group (26 cases) and combination group (29 cases). The patients in balloon dilatation group underwent bronchoscopic balloon dilatation and the patients in combination group underwent bronchoscopic balloon dilatation combined with high frequency electrocoagulation. The patients of the two groups accepted endoscopic therapy once a week. Effective rate of recanalization for the narrow airway, frequency of effective treatment and the time of tuberculosis bacterium vanishing was recorded. Intraoperative and postoperative complications were also observed. Three months after the treatment, all patients accepted bronchoscopic to observe and assess the airway restenosis rate. Results After treatment, the effective rate in balloon dilatation group and combination group had no significant difference[69.2%(18/26) vs. 89.7% (26/29 )](P＞ 0.05 ),but frequency of effective treatment and time of tuberculosis bacterium vanishing had significant difference[(3.5 ±1.3) times vs. (1.5 ± 1.1) times, (23.3 ±3.6) d vs.(13.2 ±2.3) d](P<0.01). There was no significant difference on the intraoperative and postoperative complications between two groups (P＞0.05). The airway restenosis rate was 33.3%(6/18) in balloon dilatation group and 7.7%(2/26) in combination group after treatment for 3 months (P ＜0.05). Conclusions Combination of bronchoscopic balloon dilatation and high frequency electrocoagulation is an efficacy and safety way for the tuberculosis inflammatory airway stenosis. It can reduce the frequency of interventional therapy, shorten the time of tuberculosis bacterium vanishing, and may also decrease the airway restenosis rate.
