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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (03) : 321 -324. doi: 10.3877/cma.j.issn.1674-6902.2019.03.011

所属专题： 文献；

论著

支气管镜下局部治疗支气管结核临床分析
范慧明1, 魏海龙1,†(), 罗林成1, 刘玮1   
  1. 1. 614000　四川省乐山市人民医院呼吸与危重症医学科
  • 收稿日期:2019-03-10 出版日期:2019-06-20
  • 通信作者: 魏海龙

Clinical analysis of local treatment of bronchial tuberculosis under bronchoscope

Huiming Fan1, Hailong Wei1,†(), Lincheng Luo1, Wei Liu1   

  1. 1. Department of Respiratory and Critical Care Medicine, Leshan People′s Hospital, Leshan 614000, Sichuan Province, China
  • Received:2019-03-10 Published:2019-06-20
  • Corresponding author: Hailong Wei
  • About author:
    Corresponding author: Wei Hailong, Email:
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范慧明, 魏海龙, 罗林成, 刘玮. 支气管镜下局部治疗支气管结核临床分析[J]. 中华肺部疾病杂志(电子版), 2019, 12(03): 321-324.

Huiming Fan, Hailong Wei, Lincheng Luo, Wei Liu. Clinical analysis of local treatment of bronchial tuberculosis under bronchoscope[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(03): 321-324.

目的

探讨支气管结核支气管镜下表现特征，分析纤维支气管镜下局部治疗支气管结核的临床疗效。

方法

回顾性分析四川乐山市人民医院呼吸与危重症医学科2016年1月至2017年12月收治的92例支气管结核患者的临床资料，按照随机数字表法将患者分为观察组及对照组，观察组48例，对照组44例。两组患者均采用规范化3HRZE/9HR抗结核口服药物治疗及雾化吸入治疗，观察组在此基础上采用纤维支气管镜下局部注射药物治疗。比较两组患者治疗1、2、3、6个月时痰抗酸杆菌转阴率及治疗6个月时的临床疗效，记录治疗过程中的不良反应并进行远期随访。

结果

观察组治疗3、6个月时痰菌转阴率显著高于对照组(P<0.05)；观察组治疗总有效率为85.42%，对照组为63.64%，组间比较差异具统计学意义(P<0.05)；两组患者治疗过程中不良反应无明显差异(P>0.05)。观察组48例支气管结核患者经12个月抗痨和支气管镜下局部治疗，全部临床治愈率；对照组为44例支气管结核临床治愈率为77.27%，两组患者远期临床治愈率比较差异具统计学意义(P＝0.000)。

结论

纤维支气管下局部治疗支气管结核，结合联合常规应用抗结核药物治疗，可有效促进支气管结核患者痰菌转阴，以提高临床疗效，并且可缩短治疗周期。

关键词: 纤维支气管镜, 支气管结核, 异烟肼, 临床分析
Objective

To explore the characteristics of bronchial tuberculosis under a bronchoscope and analyze the clinical effect of local treatment of bronchial tuberculosis under a fiberoptic bronchoscope.

Methods

The clinical data of 92 cases of bronchial tuberculosis admitted to the Department of Respiratory and Critical Care Medicine of Leshan People′s Hospital in Sichuan Province in China from January 2016 to December 2017 were retrospectively analyzed. The patients were divided into an observation group (n=48) and a control group (n=44) according to the random number table method. The patients in both groups were treated with the standardized 3HRZE/9HR anti-tuberculosis oral drug therapy and atomization inhalation therapy, and the patients in the observation group was treated with local drug injection under a fiberoptic bronchoscope on this basis. The sputum acid-fast bacilli negative conversion rate at 1, 2, 3 and 6 months of treatment and the clinical efficacy at 6 months of treatment were compared between the two groups. The adverse reactions during the treatment were recorded and a long-term follow-up was conducted.

Results

The sputum negative conversion rate in the observation group was significantly higher than that in the control group at 3 and 6 months of treatment (P<0.05). The total effective rates were 85.42% in the observation group and 63.64% in the control group, with a statistically significant difference between the two groups (P<0.05). There was no significant difference in the adverse reactions between the two groups (P>0.05). In the observation group, 48 cases of bronchial tuberculosis were treated with anti-tuberculosis and bronchoscopy for 12 months and were all clinically cured. The clinical cure rate of 44 cases of bronchial tuberculosis in the control group was 77.27%. The difference of the long-term clinical cure rate between the two groups was statistically significant (P=0.000).

Conclusion

Local treatment for the patients with bronchial tuberculosis under a fiberoptic bronchoscope combined with conventional anti-tuberculosis drugs can effectively promote the sputum negative transformation, improve the clinical efficacy and shorten the treatment period.

Key words: Fiberoptic bronchoscope, Bronchial tuberculosis, Isoniazid, Clinical analysis
表1 两组患者治疗后痰菌转阴情况分析[n(%)]
组　别 例数 治疗1个月 治疗2个月 治疗3个月 治疗6个月
观察组 48 5(10.41) 15(32.25) 24(50.00) 34(70.83)
对照组 44 3(6.81) 8(18.18) 14(31.82) 19(43.18)
χ2值 ? 0.618 2.091 3.13 7.188
P值 ? 0.714 0.148 0.077 0.007
表2 两组患者治疗总有效率比较[n(%)]
组　别 例数 显效 有效 无效 总有效率
观察组 48 18(37.50) 23(47.92) 7(14.58) 85.42
对照组 44 7(15.90) 21(47.72) 16(36.36) 63.64
χ2值 ? 5.408 0.000 10.401 4.043
P值 ? 0.020 0.986 0.001 0.044
表3 两组患者治疗过程中不良反应发生情况分析[n(%)]
组　别 例数 肝功能下降 皮疹 胃部不适 总不良反应
观察组 48 5(10.42) 1(2.08) 1(2.08) 7(14.58)
对照组 44 3(6.82) 1(2.27) 2(4.54) 6(13.64)
χ2值 ? 0.374 － － 0.017
P值 ? 0.541 1.0 0.605 0.896
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