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目的观察支气管镜冷冻治疗支气管结核的临床疗效及对免疫功能的影响。方法选取经支气管镜检查确诊为肉芽增殖型支气管结核的83例患者,采用在2HR(L_2)ZE(S)/10HR(L_2)E全身抗结核和异烟肼注射液雾化吸入治疗的基础上,加用支气管镜冷冻治疗,观察治疗前后的支气管镜下改变情况、临床症状及T淋巴细胞亚群变化情况。结果经支气管镜冷冻治疗后,显效率73.4%(61/83),有效率26.6%(22/83),总有效率为100%;气促分级显示治疗后患者气促症状较前明显好转(P<0.01);发热时间、咳嗽、咳痰时间以及全身乏力消失时间较对照组明显减少(P<0.01);治疗后发现观察组CD3~+、CD4~+和CD4~+/CD8~+水平均明显高于治疗前和治疗后的对照组,而CD8~+水平均明显低于治疗前和治疗后的对照组。结论经支气管镜冷冻治疗支气管结核患者疗效确切,不良反应少,安全性高。
Objective To observe the clinical efficacy of bronchoscopy in the treatment of bronchial tuberculosis and its effect on immune function. Methods Eighty-three patients diagnosed with granulo-proliferative bronchial tuberculosis by bronchoscopy were enrolled in this study. They were treated with systemic anti-tuberculosis and isoniazid injection of 2HR (L 2) ZE (S) / 10HR (L 2) E , Plus bronchoscopy cryotherapy, bronchoscopic changes before and after treatment, clinical symptoms and changes in T lymphocyte subsets. Results After bronchoscopic cryotherapy, the effective rate was 73.4% (61/83), the effective rate was 26.6% (22/83) and the total effective rate was 100%. The symptoms of shortness of breath after treatment were significantly improved (P < (P <0.01). The time of fever, cough, expectoration and the disappearance of generalized fatigue were significantly lower than those in the control group (P <0.01). After treatment, the levels of CD3 +, CD4 + and CD4 + / CD8 + Were significantly higher than before treatment and after treatment of the control group, while the CD8 ~ + levels were significantly lower than before treatment and after treatment of the control group. Conclusion Bronchoscopy is the most effective and safe method for the treatment of bronchial tuberculosis.