气管-支气管淋巴结瘘型结核的临床特征及经支气管镜介入治疗的研究

发布时间：2018-04-13 14:12

本文选题：结核 + 气管　；参考：《实用医学杂志》2014年13期

【摘要】：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。
[Abstract]:Objective: to investigate the clinical characteristics of tuberculosis with tracheobronchial lymph node fistula and to study the effect of interventional treatment with bronchoscopy.Methods: the clinical data of 50 newly treated patients with tracheobronchial lymph node fistula type tuberculosis diagnosed in our hospital from January 2008 to January 2013 were retrospectively analyzed.The change of bronchoscopy and sputum negative time were used to evaluate the effect of bronchoscopic interventional therapy and follow up for 6 months.Results among the 50 patients, the most common site of bronchial fistula was right middle lobe (24 / 12 / 50), and the total effective rate was 98 / 49 / 50 / 50 after total chemotherapeutic bronchoscopy interventional therapy.The complications of interventional therapy were hemoptysis (8 / 4 / 50), stable lesions in 49 cases of effective patients after 6 months follow-up, smooth bronchial mucosa under tracheoscopy, no obvious granulation and cheese necrosis.Conclusion: the tuberculosis of tracheobronchial lymph node fistula mainly destroys the trachea wall by the inflammatory invasion of tuberculosis, and the necrotic substance obstructs the airway to cause the corresponding clinical manifestation.The treatment of tracheobronchial lymph node fistula tuberculosis by local clamp and drug injection via bronchoscope is effective and has less complications.
【作者单位】：广州医科大学;广州市胸科医院内科;广州市胸科医院内镜中心;
【分类号】：R523

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