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1、第16卷第9期中国内镜杂志Vol.16No.92010年9月ChinaJournalofEndoscopySep.2010文章编号：1007-1989（2010）09-0945-03经支气管镜介入冷冻治疗支气管结核22例临床分析*林明贵，张广宇，李燕峰，刘倩颖，王丽苹，杨坤，盛莉，唐静（解放军第309医院全军结核病研究所，北京100091）摘要：目的探讨经支气管镜介入冷冻治疗支气管结核的疗效。方法经支气管镜介入对22例溃疡坏死型及肉芽增殖型的支气管结核患者进行病变局部冷冻治疗，同时进行全身综合抗结核及雾化治疗，比较治疗前后
2、患者临床症状、镜下表现及影像学检查，以观察其疗效。结果22例患者经过平均治疗1.5个月，（5±3）次/例的冷冻治疗，临床症状改善明显，原气管、支气管内膜病变绝大部分吸收，肺部病变明显吸收，原狭窄的管腔通畅，阻塞性肺炎和肺不张均消退，但仍有7例残留轻度病变支气管狭窄。显效68.18%（15/22），有效31.81%（7/22），总有效率100%。未见明显不良反应。结论支气管镜介入冷冻治疗可使溃疡坏死型及肉芽增殖型支气管结核患者迅速改善咳嗽、呼吸困难等临床症状，加速气管、支气管局部病变的吸收好转，有效解除病变造成的阻塞性肺炎及
3、肺不张，明显提高抗结核治疗效果，是一种简便、有效、安全的微创方法。关键词：支气管镜；介入方法；冷冻治疗；结核病中图分类号：R523文献标识码：BTreating22casesofendobronchialtuberculosiswith*endoscopicinterventionalcryotherapyLINMing-gui,ZHANGGuang-yu,LIYan-feng,LIUQian-ying,WANGLi-ping,YANGKun,SHENGLi,TANGJing(TuberculosisResearchIns
4、tituteofthe309thHospitalofPLA,Beijing100091,P.R.China)Abstratct:【Objective】Toapproachtheeffectivenessoftreatingendobronchialtuberculosiswithendoscopicinterventionalcryotherapy.【Methods】Inadditiontochemotherapyandpulverizinginhalation,doingendoscopicfo－calfreezingo
5、n22casesofendobronchialtuberculosis,whichcomposedofulcerativenecrotictypeandproliferatingtype.Thesymptoms,endoscopicappearancesandrentogenographicfilmsbeforeandaftertreatmentwascompared.【Results】The22casespatientunderwent(5±3)timescryotherapyinthemeancourseof1.5mo
6、nths,showedmarkedimprovementinclinicalsymptoms,absorptionofluminalfociinbronchi,disappearanceofplaquesinchestplainfilm,reconstructionofstenoticlumen,cureofatelectasisandsecondarypneumonia;only7casesofpatientcar－riedreminiscentstenosisofbronchial;theregimeisprovedm
7、arkedlyeffectivein68.18%ofourcohort;effectivein31.81%,so100%effectivewithnoadversereaction.【Conclusions】Treatingendobronchialtuberculosiswithendo－scopicinterventionalcryotherapyshowedantitussiveandrelieverespiretarydistressinshortterm,promotingtheab－sorptionoflumi
8、nalfoci,effectivelyalleviatingtheatelectasisandobstructivepneumonia.Sothisregimeissimpleef－fectiveandsafe.Keywords:trachealendoscope;intervention;cryoth
