CAJ | 학술논문

目的：探讨气管-支气管淋巴结瘘型结核的临床特征，研究经支气管镜介入治疗的效果。方法：对我院2008年1月至2013年1月住院确诊为气管-支气管淋巴结瘘型结核并接受支气管镜介入治疗的50例初治患者的临床资料进行回顾性分析，通过临床症状改善程度、支气管镜下改变及痰菌阴转时间等指标评价支气管镜介入治疗的效果，并随访6个月。结果：50例患者中，支气管瘘口分布最常见部位为右中叶，占24％（12/50）；全身化疗＋支气管镜介入治疗后总有效率达98％（49/50）。介入治疗的并发症主要为咯血，占8％（4/50）；经6个月随访，49例有效患者病灶均稳定，复查气管镜见支气管黏膜光滑，无明显肉芽及干酪坏死物阻塞。结论：气管-支气管淋巴结瘘型结核主要通过结核炎症侵袭破坏气管管壁、坏死物阻塞气道引起相应临床表现，经支气管镜局部钳夹及药物注射介入治疗气管-支气管淋巴结瘘型结核效果好，并发症少。
목적：탐토기관-지기관림파결루형결핵적림상특정，연구경지기관경개입치료적효과。방법：대아원2008년1월지2013년1월주원학진위기관-지기관림파결루형결핵병접수지기관경개입치료적50례초치환자적림상자료진행회고성분석，통과림상증상개선정도、지기관경하개변급담균음전시간등지표평개지기관경개입치료적효과，병수방6개월。결과：50례환자중，지기관루구분포최상견부위위우중협，점24％（12/50）；전신화료＋지기관경개입치료후총유효솔체98％（49/50）。개입치료적병발증주요위각혈，점8％（4/50）；경6개월수방，49례유효환자병조균은정，복사기관경견지기관점막광활，무명현육아급간락배사물조새。결론：기관-지기관림파결루형결핵주요통과결핵염증침습파배기관관벽、배사물조새기도인기상응림상표현，경지기관경국부겸협급약물주사개입치료기관-지기관림파결루형결핵효과호，병발증소。
Objective To explore the clinical features of transbronchial tuberculous mediastinal lymph-adenitis and value of bronchoscopic interventional therapy. Methods The clinical data of 50 patients who had been diagnosed as tuberculous mediastinal lymphadenitis and had received bronchoscopic interventional therapy in our hospital during the period from January 2008 to January 2013 were retrospectively analyzed. The bronchoscopic change , improvement in symptoms , and time to sputum smear and culture conversion were used to assess the therapeutic effect. The patients were followed up for six months. Results The mean age of the patients was (35 ± 15) years and the male to female ratio was 1:1.2. The lesions occurred mostly at the right middle lobe in 24% (12/50) of the patients. The total effectiveness rate was up to 98% (49/50) after chemotherapy and bronchoscopic interventional therapy. The major complication associated with interventional therapy was hemoptysis (8%, 4/50). After follow-up of 6 months , 49 patients with active lesions were stable , with smooth bronchial mucosa and no obvious obstruction by granulation and caseous necrosis tissues. Conclusions The relavent clinical symptoms of transbronchial tuberculous mediastinal lymphadenitis is mainly caused by tuberculosis inflammation which destroys and blocks the airway. The fiber bronchoscopic therapy with forceps clip and drug infusion has a definite effect and fewer complications.