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中国防痨杂志 ›› 2011, Vol. 33 ›› Issue (2): 99-103.

• 论著 • 上一篇    下一篇

氩等离子体凝固和冷冻序贯治疗支气管结核

陈志 张广宇 梁建琴 王金河 唐静 王玲玲   

  1. 解放军309医院全军结核病研究所, 北京, 100091
  • 收稿日期:2010-04-28 出版日期:2011-02-20 发布日期:2012-01-19
  • 基金资助:

    "十一五"重大传染病防治专项课题(2008ZX10003-016)

uential therapy of endobronchial tuberculosis by argon plasma coagulation and cr

Chen Zhi,Zhang Guangyu,Liang Jianqin,Wang Jinhe,Tang Jing,Wang Lingling   

  1. Tuberculosis research institute of PLA, the 309 th hospital of PLA, Beijing 100091, China
  • Received:2010-04-28 Online:2011-02-20 Published:2012-01-19
  • Contact: Chen Zhi E-mail:chenzhidoctor@126.com

摘要: 目的 探讨经支气管镜行氩等离子体凝固和冷冻序贯治疗支气管结核的临床疗效和安全性。 方法 将经痰或支气管肺泡灌洗液抗酸染色涂片、培养,影像学和支气管镜检查及病理结果确诊36例支气管结核患者纳入观察范围,常规抗结核化疗基础上,在支气管镜下行氩等离子体凝固和冷冻序贯治疗,并追踪观察治疗结果。以患者治疗后的主要症状、体征缓解情况,胸部X线或CT扫描,支气管镜复查观察病灶大小、气道黏膜、管腔通畅情况为疗效判断依据,评价治疗结果,同时观察不良反应及并发症。 结果 36例支气管结核患者行氩等离子体凝固序贯冷冻治疗,平均治疗(4±2)次/例,完全有效24例(66.7%),部分有效10例(27.8%),轻度有效2例(5.6%)。所有病例未见严重不良反应及并发症。 结论 氩等离子体凝固和冷冻序贯治疗支气管结核不但可以快速使气道恢复通畅,缓解病人临床症状,还可有效地控制肉芽增生,使治疗后的局部组织创面光滑。氩等离子体凝固和冷冻序贯治疗支气管结核是一种无明显并发症和不良反应,安全有效的方法。

关键词: 结核, 支气管/治疗, 氩, 冷冻疗法

Abstract: Objective To evaluate the efficacy, indications and the possible side effects of sequential therapy of endobronchial tuberculosis by argon plasma coagulation and cryotherapy.  Methods Thirty-six patients with endobronchial tuberculosis that were diagnosed by acid-fast stain and culture of sputum(bronchoalveolar lavage fluid), radiology, bronchoscopy and pathology were studied. Sequential therapy by argon plasma coagulation and cryotherapy were performed on the basis of antituberculosis chemotherapy. Efficacy and complication were assessed and followed up after the sequential therapy.  Results Efficacy was assessed by symptoms, physical signs, radiology and bronchoscopy. Thirty-six patients with endobronchial tuberculosis were treated 4±2 times by the sequential therapy. The significant improvement rate was 66.7%(24/36 patients), the clinical effective rate was 27.8%(10/36 patients), the light effective rate was 5.6%(2/36 patients). Severe adverse effects have not found in all the patients.  Conclusions The sequential therapy by argon plasma coagulation and cryotherapy could rapidly relieve clinical symptoms and inhibit efficiently granulation. The sequential therapy by argon plasma coagulation and cryotherapy is an effective and safe method of treatment in patients with endobronchial tuberculosis.

Key words: tuberculosis,bronchi/therapy, argon, cryotherapy