發(fā)布時間：2018-04-13 14:12

  本文選題：結(jié)核 + 氣管��； 參考：《實用醫(yī)學(xué)雜志》2014年13期

【摘要】：目的:探討氣管-支氣管淋巴結(jié)瘺型結(jié)核的臨床特征,研究經(jīng)支氣管鏡介入治療的效果。方法:對我院2008年1月至2013年1月住院確診為氣管-支氣管淋巴結(jié)瘺型結(jié)核并接受支氣管鏡介入治療的50例初治患者的臨床資料進(jìn)行回顧性分析,通過臨床癥狀改善程度、支氣管鏡下改變及痰菌陰轉(zhuǎn)時間等指標(biāo)評價支氣管鏡介入治療的效果,并隨訪6個月。結(jié)果:50例患者中,支氣管瘺口分布最常見部位為右中葉,占24%(12/50);全身化療+支氣管鏡介入治療后總有效率達(dá)98%(49/50)。介入治療的并發(fā)癥主要為咯血,占8%(4/50);經(jīng)6個月隨訪,49例有效患者病灶均穩(wěn)定,復(fù)查氣管鏡見支氣管黏膜光滑,無明顯肉芽及干酪壞死物阻塞。結(jié)論:氣管-支氣管淋巴結(jié)瘺型結(jié)核主要通過結(jié)核炎癥侵襲破壞氣管管壁、壞死物阻塞氣道引起相應(yīng)臨床表現(xiàn),經(jīng)支氣管鏡局部鉗夾及藥物注射介入治療氣管-支氣管淋巴結(jié)瘺型結(jié)核效果好,并發(fā)癥少。
[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.
【作者單位】： 廣州醫(yī)科大學(xué);廣州市胸科醫(yī)院內(nèi)科;廣州市胸科醫(yī)院內(nèi)鏡中心;
【分類號】：R523

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