中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2014年
19期
15-17
,共3页
淋巴结瘘型气管支气管结核%支气管镜介入%冷冻消融
淋巴結瘺型氣管支氣管結覈%支氣管鏡介入%冷凍消融
림파결루형기관지기관결핵%지기관경개입%냉동소융
Lymph nodes fistula type tracheobronchial TB%Bronchoscopy intervention%Cryoablation
目的：通过临床病例资料分析，评价支气管镜下不同组合方式治疗淋巴结瘘型气管支气管结核(TBTB)的效果，以提出最佳治疗方案。方法选择2009年6月-2012年12月收治的38例淋巴结瘘型TBTB患者，根据介入方式分为3组，A组采用局部注如抗结核药物及活检钳病灶清除术，B组采用局部注如抗结核药物及活检钳病灶清除术及冷冻消融术，C组采用局部注如抗结核药物及冷冻消融术。评价不同介入组合的疗效及并发症，各组间病例资料采用四格表χ2检验。结果38例患者中治疗12月时治愈25例，治愈率为65.8%（25/38），好转13例，总体有效率100%。A组平均支气管镜介入次数（20±4.0）次，B组平均支气管镜介入次数（12±3.0次），C组平均支气管镜介入次数（11±4.0）次，C组与A组比较差异有统计学意义（P<0.05）。3组出血发生率分别为A组77.0%，B组84.0%，C组60.0%，与A B组比较（P<0.05）。 C组患者治疗第2、第6月、12月的治愈率显著高于A B两组（P<0.05）。结论淋巴结瘘型TBTB采用支气管镜下局部注如抗结核药物及冷冻消融术可减少支气管镜介入治疗次数，出血并发症少。
目的：通過臨床病例資料分析，評價支氣管鏡下不同組閤方式治療淋巴結瘺型氣管支氣管結覈(TBTB)的效果，以提齣最佳治療方案。方法選擇2009年6月-2012年12月收治的38例淋巴結瘺型TBTB患者，根據介入方式分為3組，A組採用跼部註如抗結覈藥物及活檢鉗病竈清除術，B組採用跼部註如抗結覈藥物及活檢鉗病竈清除術及冷凍消融術，C組採用跼部註如抗結覈藥物及冷凍消融術。評價不同介入組閤的療效及併髮癥，各組間病例資料採用四格錶χ2檢驗。結果38例患者中治療12月時治愈25例，治愈率為65.8%（25/38），好轉13例，總體有效率100%。A組平均支氣管鏡介入次數（20±4.0）次，B組平均支氣管鏡介入次數（12±3.0次），C組平均支氣管鏡介入次數（11±4.0）次，C組與A組比較差異有統計學意義（P<0.05）。3組齣血髮生率分彆為A組77.0%，B組84.0%，C組60.0%，與A B組比較（P<0.05）。 C組患者治療第2、第6月、12月的治愈率顯著高于A B兩組（P<0.05）。結論淋巴結瘺型TBTB採用支氣管鏡下跼部註如抗結覈藥物及冷凍消融術可減少支氣管鏡介入治療次數，齣血併髮癥少。
목적：통과림상병례자료분석，평개지기관경하불동조합방식치료림파결루형기관지기관결핵(TBTB)적효과，이제출최가치료방안。방법선택2009년6월-2012년12월수치적38례림파결루형TBTB환자，근거개입방식분위3조，A조채용국부주여항결핵약물급활검겸병조청제술，B조채용국부주여항결핵약물급활검겸병조청제술급냉동소융술，C조채용국부주여항결핵약물급냉동소융술。평개불동개입조합적료효급병발증，각조간병례자료채용사격표χ2검험。결과38례환자중치료12월시치유25례，치유솔위65.8%（25/38），호전13례，총체유효솔100%。A조평균지기관경개입차수（20±4.0）차，B조평균지기관경개입차수（12±3.0차），C조평균지기관경개입차수（11±4.0）차，C조여A조비교차이유통계학의의（P<0.05）。3조출혈발생솔분별위A조77.0%，B조84.0%，C조60.0%，여A B조비교（P<0.05）。 C조환자치료제2、제6월、12월적치유솔현저고우A B량조（P<0.05）。결론림파결루형TBTB채용지기관경하국부주여항결핵약물급냉동소융술가감소지기관경개입치료차수，출혈병발증소。
Objective To evaluate the effect of different combinations of bronchoscopic treatment of lymph nodes fistula type tra-cheobronchial tuberculosis (TBTB) by analyzing the clinical data so as to put forward the best treatment. Methods 38 cases of lymph nodes fistula type TBTB patients admitted in our hospital from June, 2009 to December, 2012 were divided into 3 groups according to the intervention method. Patients in A group were treated with local injection of anti-TB drugs and biopsy forceps de-bridement. Patients in B group were treated with local injection of anti-TB drugs and biopsy forceps debridement and cryoablation. Patients in C group were treated with local injection of anti-TB drugs and cryoablation. The efficacy and complications of different intervention combinations were evaluated, the data of the groups of patients adopted chi-square test of four-fold table. Results Of the 38 cases of patients, at the 12 months' treatment, 25 cases were cured, the cure rate was 65.8%(25/38), improved in 13 cases, the overall efficiency was 100%. The average bronchoscopic interventional times of A group were (20 ±4.0)times, and those of B group were(12±3.0) times, those of C group were 11±4.0 times, the difference between A group and C group was statistically signif-icant(P<0.05). the incidence of bleeding of A group, B group, C group was 77.0%, 84.0%, 60.0%, respectively, compared with A group and B group(P<0.05). The cure rate of C group at the treatment of 2 months, 6 months and 12 months was much higher than that of A group and B group (P<0.05). Conclusion Lymph nodes fistula type tracheobronchial tuberculosis (TBTB) using broncho-scopic local injection of anti-TB drugs and cryoablation therapy can reduce the number of interventional bronchoscopy with less bleeding complications.
