药物雾化吸入疗法联合纤支镜介入疗法治疗支气管内膜结核患者的疗效分析

佟勃杉

[摘要] 目的 探討抗结核药物雾化吸入疗法联合纤支镜介入疗法治疗支气管内膜结核的可行性。 方法 选取2018年3月～2019年3月在沈阳市第十人民医院住院治疗的80例支气管内膜结核患者作为研究对象，将患者随机分为两组，各40例。对照组予2HRZE/10HR方案口服药物抗结核治疗，研究组在对照组基础上，应用抗结核药物雾化吸入疗法联合纤支镜介入疗法。比较两组患者治疗效果、治疗的总疗程、不良反应及并发症的发生率。结果 研究组在总有效率、痰菌转阴时间及总治疗疗程方面分别为92.5%、（28.77±4.12）d、（39.2±6.28）周，相对于对照组的为75.0%、（39.49±5.72）d、（47.3±6.65）周，两组差异均有统计学意义（P<0.05）。除术中出血方面两组有统计学差异（P<0.05）外，两组其余不良反应者无明显差异（P>0.05）。 结论 对EBTB 患者，在常规抗结核治疗基础上联合使用药物雾化吸入疗法和纤维支气管镜介入疗法治疗可迅速缓解患者临床症状，缩短菌阳患者的痰菌转阴时间及治疗疗程，促进肺不张恢复，提高治疗效果。

[关键词] 支气管内膜结核;雾化吸入;介入治疗;肺不张

[中图分类号] R521          [文献标识码] B          [文章编号] 1673-9701（2020）16-0040-03

Analysis on the efficacy of drug atomized inhalation therapy combined with bronchofiberscopy interventional therapy in the treatment of patients with endobronchial tuberculosis

TONG Boshan

Department of Tuberculosis， Shenyang Tenth People's Hospital， Shenyang   110044， China

[Abstract] Objective To explore the feasibility of antituberculosis drug atomized inhalation therapy combined with bronchofibers-copy interventional therapy in the treatment of patients with endobronchial tuberculosis. Methods 80 patients with endobronchial tuberculosis who were hospitalized in Shenyang Tenth People's Hospital from March 2018 to March 2019 were selected as the study subjects. The patients were randomLy divided into two groups， each group had 40 patients the control group was given 2HRZE/10HR regimen of oral drug administration for antituberculosis treatment. Based on the control group， the study group was given antituberculosis drug atomized inhalation therapy combined with bronchofiberscopy interventional therapy. The therapeutic effect was compared between the two groups of patients， the total course of treatment was compared between the two groups of patients， and the incidence of adverse reactions and complications was compared between the two groups. Results The total effective rate， the sputum negative conversion time and the total course of treatment were 92.5%， （28.77±4.12） days， and （39.2±6.28） weeks in the study group compared with 75.0%， （39.49±5.72） days， and （47.3±6.65） weeks in the control group， respectively. The differences between the two groups were statistically significant （P<0.05）. Except for intraoperative hemorrhage， which was a statistically significant difference between the two groups （P<0.05）， there were no statistically significant differences in the other adverse reactions between the two groups （P>0.05）. Conclusion For the patients with EBTB， the combination of drug atomized inhalation therapy and bronchofiberscopy interventional therapy based on conventional antituberculosis treatment can quickly relieve clinical symptoms of patients， shorten the sputum negative conversion time and the treatment course， promote the recovery of atelectasis and improve the therapeutic effect in the patients with positive bacteria results.

[Key words] Endobronchial tuberculosis; Atomized inhalation; Interventional therapy; Atelectasis

支气管内膜结核（Endobronchial tuberculosis，EBTB）是结核菌感染支气管黏膜、支气管黏膜下层及支气管，从而引起的一种结核病，其发展过程中容易引起肺不张[1]。大多数初期的肺不张是可以逆转的[2]，但一旦错过了最佳治疗时间则易造成大量组织增生纤维化，使肺部有效体积减少，形成不可逆的肺萎缩，从而严重影响患者肺功能，甚至危及生命[3]。随着诊治技术的提升，人们逐渐发现，对EBTB患者在使用全身抗结核化疗疗的基础上加用纤支镜介入疗法，或者对其予结核药物雾化吸入疗法，均可明显提高其治疗的效果[4，5]。……