论文部分内容阅读
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。
Objective: To investigate the clinical features of tracheobronchial fistula-type tuberculosis and to investigate the effect of bronchoscopic interventional therapy. Methods: The clinical data of 50 newly diagnosed patients diagnosed as tracheobronchial fistula type tuberculosis admitted to our hospital from January 2008 to January 2013 were retrospectively analyzed. According to the clinical symptom improvement, Bronchoscopic changes and sputum negative conversion time and other indicators evaluate the effect of bronchial interventional therapy and follow-up of 6 months. Results: Of the 50 patients, the most common site of bronchial fistula distribution was the right middle lobe, accounting for 24% (12/50). The total effective rate was 49% (49/50) after systemic chemotherapy and bronchoscopic intervention. Complications of interventional treatment were mainly hemoptysis, accounting for 8% (4/50). After 6 months of follow-up, the lesions of 49 effective patients were stable. Bronchial mucosa was found smooth after tracheoscope. Conclusion: Tuberculosis of tracheobronchial lymph node fistula mainly damages the endotracheal tube wall through inflammation of tuberculosis, and the necrotic obstruction of the airway leads to the corresponding clinical manifestations. The bronchial bronchial lymphatic fistula type tuberculosis is effective by local bronchoscopic clamp and drug injection intervention, Less complications.