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目的探讨经纤维支气管镜高频电刀联合灌注化疗治疗支气管内膜结核的疗效及安全性。方法对15例支气管内膜结核经纤维支气管镜高频电灼扩大管腔,同时配合镜下注入抗结核药,观察近期、远期疗效及安全性。结果15例患者治疗后支气管完全通畅率66.7%,总有效率93.3%。1例患者治疗2次管腔未通,14例患者阻塞性肺不张、肺炎得到缓解,经全身三联或四联抗结核治疗12～18个月病情稳定。高频电刀治疗无出血、气胸、纵隔气肿、气管食管瘘及气管内烧伤、感染等并发症发生。结论经纤维支气管镜高频电刀联合灌注化疗治疗支气管内膜结核,可解除气道梗阻,促进病灶吸收,抗结核药直接在病变部位发挥杀菌、抑菌作用,因而疗效确切、并发症少。
Objective To investigate the efficacy and safety of bronchofibroscope combined with high-frequency electrosurgical combined with infusion chemotherapy in the treatment of endobronchial tuberculosis. Methods Fifteen cases of endobronchial tuberculosis were treated with high-frequency electrocautery by bronchoflulectomy to enlarge the lumen. At the same time, anti-tuberculosis drugs were injected under the microscope to observe the short-term and long-term efficacy and safety. Results 15 cases of patients with bronchial patency rate of 66.7%, the total effective rate 93.3%. One patient had failed to pass the lumen twice, 14 patients had obstructive atelectasis, pneumonia was relieved, and the condition was stable after 12-18 months of systemic triple or quadruple antituberculosis treatment. High-frequency knife treatment of bleeding, pneumothorax, mediastinal emphysema, tracheoesophageal fistula and tracheal burns, complications such as infection. Conclusion The treatment of endobronchial tuberculosis by bronchofibroscopy combined with electrosurgical infusion chemotherapy can relieve the airway obstruction and promote the absorption of the lesion. The antituberculotics exerts the bactericidal and bacteriostatic effects directly on the diseased parts. Therefore, the curative effect is definite and there are few complications.