【摘要】：目的:探討應(yīng)用支氣管鏡局部噴灑絲裂霉素C(MMC)在治療結(jié)核性中心氣道瘢痕狹窄中的臨床療效。方法:將結(jié)核性中心氣道瘢痕狹窄患者45例隨機(jī)分為對(duì)照組(14例)、治療1組(15例)和治療2組(16例),分別進(jìn)行常規(guī)球囊擴(kuò)張、常規(guī)球囊擴(kuò)張加局部噴灑1次MMC和2次MMC治療,以治療前、治療結(jié)束時(shí)及治療后3、6、12個(gè)月的MRC評(píng)分和氣道直徑為指標(biāo)考察其臨床療效。結(jié)果:(1)各觀察時(shí)間點(diǎn)的MRC評(píng)分:治療后3個(gè)月治療2組(0.06±0.25)與治療1組(0.33±0.617)MRC評(píng)分均顯著低于對(duì)照組(0.57±0.756)(均P0.05)。其他各時(shí)間點(diǎn)3組MRC評(píng)分差異均無顯著性。(2)各觀察時(shí)間點(diǎn)的氣道直徑:治療后3、6個(gè)月治療2組氣道平均直徑顯著大于對(duì)照組與治療1組(P0.01,P0.05);治療后12個(gè)月治療2組氣道平均直徑顯著大于治療1組(P0.05)。其他各時(shí)間點(diǎn)3組氣道平均直徑差異均無顯著性(P0.05)。結(jié)論:球囊擴(kuò)張術(shù)時(shí)局部噴灑MMC對(duì)改善結(jié)核性氣道瘢痕狹窄患者呼吸困難癥狀、維持?jǐn)U張后氣道直徑方面具有一定的近、遠(yuǎn)期臨床療效。
[Abstract]:Objective: to investigate the clinical effect of local spraying of mitomycin C (MMC) with bronchoscope in the treatment of tuberculous central airway scar stenosis. Methods: Forty-five patients with tuberculous central airway scar stenosis were randomly divided into control group (n = 14), treatment group (n = 15) and treatment group (n = 16). Routine balloon dilatation combined with local spraying of 1 MMC and 2 MMC were used to evaluate the clinical efficacy of MRC score and airway diameter before treatment, at the end of treatment and 3 months after treatment. Results: (1) the MRC score of each observation time point: the MRC score of treatment group (0.06 鹵0.25) and treatment group 1 (0.06 鹵0.25) was significantly lower than that of control group (0.57 鹵0.756) 3 months after treatment (P0.05). There was no significant difference in MRC scores among the other three groups. (2) the airway diameter of each observation time point: the mean airway diameter of treatment group 3 months and 6 months after treatment was significantly larger than that of control group and treatment group 1 (P0.01P 0.05). At 12 months after treatment, the mean airway diameter of treatment group was significantly larger than that of treatment group 1 (P0.05). There was no significant difference in the mean airway diameter among the three groups at other time points (P0.05). Conclusion: local spraying of MMC during balloon dilatation can improve the symptoms of dyspnea and maintain the airway diameter after dilatation in patients with tuberculous airway scar stenosis.
【作者單位】： 廣州市胸科醫(yī)院;
【基金】：廣東省科技廳計(jì)劃項(xiàng)目(編號(hào):2013B021800077) 廣州市衛(wèi)生局項(xiàng)目(編號(hào):20121A011085)
【分類號(hào)】：R52

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