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[目的]探讨纤维支气管镜(纤支镜)在支气管结核(EBTB)诊断及治疗中的应用价值。[方法]分析福州肺科医院385例住院的初治EBTB患者,比较治疗前行纤支镜刷检涂片及灌洗液找抗酸杆菌(AFB)、纤支镜活组织病理检查和痰涂片检查AFB的阳性率差异。将385例患者随机分为治疗组(195例)和对照组(190例)。治疗组在常规全身化疗的同时+雾化抗结核+支气管镜局部治疗;对照组仅常规化疗+雾化抗结核治疗。随访观察1年以上,对比分析两组的临床疗效。[结果]经纤支镜刷检涂片及灌洗液找AFB或气管镜活检病理总阳性率(78.4%)高于痰检阳性率(34.0%);治疗组治疗后的2个月、6个月和1年的痰菌转阴率、空洞闭合率均高于对照组;治疗组复发率较低。[结论]纤支镜检查可提高EBTB检出率。在常规口服及雾化抗结核治疗基础上加入支气管镜局部治疗,可提高EBTB治疗的疗效并改善预后。
[Objective] To investigate the value of bronchoscopy (bronchoscopy) in the diagnosis and treatment of bronchial tuberculosis (EBTB). [Methods] 385 hospitalized patients with newly diagnosed EBTB in Fuzhou Pulmonary Hospital were studied. AFB, fibrobronchial biopsy and sputum smear Check the positive rate of AFB differences. 385 patients were randomly divided into treatment group (195 cases) and control group (190 cases). At the same time, the treatment group was treated with atomized anti-tuberculosis + bronchoscopy while the conventional systemic chemotherapy was performed. In the control group, only conventional chemotherapy + atomized anti-TB treatment was used. Follow-up observation of more than 1 year, comparative analysis of the clinical efficacy of the two groups. [Results] The total positive rate of pathological examination by AFB or bronchoscopy was higher (78.4%) than that by sputum examination (34.0%) by fiberoptic brush smear and lavage fluid. In the treatment group 2 months after treatment, 6 Month and 1 year sputum negative rate, the void closure rate was higher than the control group; treatment group, the recurrence rate is low. [Conclusion] Fiberoptic bronchoscopy can improve the detection rate of EBTB. The addition of bronchoscopic topical therapy to conventional oral and nebulized anti-TB therapy can improve the efficacy of EBTB therapy and improve prognosis.