目的探讨经电子支气管镜下冷冻及病灶内注射药物-第三军医大学学报.DOCVIP

支气管镜冷冻及注药联合雾化治疗溃疡坏死型支气管结核 李光明 孙坚 杨蓉美 陈中书3 殷塔耀3（南昌大学医学院 江西 南昌 330006） 【摘要】 目的 探讨经电子支气管镜下冷冻、注药联合超声雾化吸入抗结核药物治疗溃疡坏死型支气管结核的效果与安全。方法 于2012年6月至2014年5月在我院住院诊断为溃疡坏死型支气管结核的患者64人，半随机分为冷冻组32例（A组）和冷冻+雾化组32例（B组）。全部患者在全身抗结核治疗的同时，间隔1～2周进行支气管镜冷冻治疗1次，每月治疗2～4次，共治疗3个月，或病灶局部粘膜基本修复终止治疗。B组用异烟肼0.2g+阿米卡星0.2g+生理盐水20ml，每日2次超声雾化吸入，共3个月，此外，于每次冷冻治疗后在病灶局部经支气管镜注入异烟肼0.2g+阿米卡星0.2g+地塞米松2.5mg。治疗前、治疗每个月及治疗第4个月观察患者的临床症状、体征及支气管镜下的改变。结果 在治疗3个月后，A组电子支气管镜下的总有效率为75%，B组为96.88%，两组间比较有统计学差异（P0.05）；且B组支气管镜介入治疗的次数（7.15±1.32）明显低于A组（8.42±1.95）（P0.05）。两组均未出现严重并发症。结论 支气管镜下冷冻、注药联合雾化药物治疗溃疡坏死型支气管结核的效果好，能较快地促进病灶的吸收、恢复支气管的通畅，减少支气管狭窄等并发症的发生。 【关键词】支气管结核；治疗；支气管镜；冷冻；注药；雾化 Efficacy and safety of bronchoscopic cryotherapy and drug injection combined with inhalation for ulcer necrosis endobronchial tuberculosis Li Guangming1 ,Sun Jian2, Yang Rongmei3, Chen Zhongshu3, Yin Tayao3 (Medical college of Nanchang University, Jiangxi, Nanchang 330006) [Abstract] Objective To investigate the efficacy and safety of bronchoscopic cryotherapy and drug injection combined with ultrasonic atomizing inhalation of anti-tuberculosis drugs for ulcer necrosis endobronchial tuberculosis. Methods 64 patients in hospital diagnosed as necrosis endobronchial tuberculosis from 2012 June to 2014 May, were quasi-randomly divided into frozen group (A group) and frozen combined with inhalation group (group B), 32 cases in each group, respectively. All patients in the systemic anti-tuberculosis treatment at the same time, were bronchoscope freezing treatment at an interval of 1 to 2 weeks, 2~4 times a month, a total of 3 months, or the treatment terminated as local lesions repaired almost completely. Ultrasonic atomizing inhalation with isoniazid 0.2g+ Amikacin 0.2g+ saline 20ml, 2 times daily, for 3 months, in group B.in addition, isoniazid 0.2g+ Amikacin 0.2g+ dexamethasone 2.5mg poured into the local lesions with bronchoscopy after cryotherapy. Observe the clinical symptoms and signs, and the manifestation of bronchial lesions of the patients b