经支气管镜介入冷冻治疗支气管结核的临床效果观察被引量：10

Clinical effect of interventional therapy and cryosurgery by bronchoscopy in the treatment of bronchial tuberculosis

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摘要目的观察经支气管镜介入冷冻治疗支气管结核的临床疗效.方法选择支气管结核患者70例,采用区组随机化分组法分为两组,每组35例.药物治疗组采用药物治疗,综合治疗组在药物治疗基础上用支气管镜介入冷冻治疗.比较两组总有效率,咳嗽、呼吸困难改善时间、治疗次数,治疗前后患者生活质量水平的差异.结果综合治疗组总有效率高于药物治疗组（综合治疗组总有效率94.29％,药物治疗组总有效率77.14％,x2=4.200,P=0.04）;综合治疗组咳嗽、呼吸困难改善时间短于药物治疗组,治疗次数少于药物治疗组[综合治疗组咳嗽、呼吸困难改善时间、治疗次数分别为（7.51±1.41）d、（4.51 ±1.61）d、（5.62±1.21）次,药物治疗组咳嗽、呼吸困难改善时间、治疗次数分别为（9.39±2.77）d、（5.39±2.57）d、（7.61±2.59）次,t=8.213、9.153、10.242,均P=0.00）;治疗前,两组生活质量评分差异无统计学意义（P＞0.05）;治疗后,综合治疗组生活质量评分改善幅度更大（综合治疗组治疗前、后比较：生理功能t=15.539,P＜0.001;情感功能t=11.798,P＜0.001;社会功能t=8.753,P＜0.001.药物治疗组治疗前、后比较：生理功能t=10.128,P＜0.001;情感功能t=8.132,P＜0.001;社会功能t=6.931,P＜0.001.综合治疗组治疗后与药物治疗组比较：生理功能t=7.433,P＜0.001;情感功能t=4.692,P＜0.001;社会功能t=3.297,P＜0.001）.结论支气管镜介入冷冻治疗支气管结核的临床疗效确切,可有效改善患者临床症状,促进病灶吸收,缩短症状消退的时间,减少治疗次数,有助于提高患者生活质量,值得推广应用. Objective To study the clinical effect of interventional therapy and cryosurgery by bronchoscopy in the treatment of bronchial tuberculosis.Methods 70 cases with bronchial tuberculosis were randomly divided into two groups 35 cases in each group.The drug treatment group was treated by internal medicine,and the combination therapy group was treated by the interventional therapy of the bronchus mirror on the basis of the drug treatment group.The total effective rate,the improvement time of cough and dyspnea,the number of treatment,the quality of life of patients were compared between the two groups.Results The total effective rate of the combination therapy group was higher than the drug treatment group （94.24％ vs 77.14％,x2 =4.200,P =0.04）.The improvement time of cough and dyspnea in the comprehensive treatment group was shorter than those in the drug treatment group,the treatment times was less than that in the drug treatment group[comprehensive treatment group：（7.51 ± 1.41） d,（4.51 ± 1.61） d,（5.62 ± 1.21） times;drug treatment group：（9.39 ± 2.77） d,（5.39 ± 2.57） d,（7.61 ± 2.59） times;t =8.213,9.153,10.242,all P =0.00].Before treatment,the life quality scores between the two groups had no significant difference （P ＞ 0.05）.After treatment,the improvement of quality of life in the combination therapy group was more significant[before treatment and after treatment of combination therapy group：physiological function：t =15.539,P ＜ 0.001;emotional function：t =11.789,P ＜ 0.001;social function：t =8.753,P ＜ 0.001.Before treatment and after treatment of drug treatment group：physiological function：t =10.128,P ＜ 0.001;emotional function：t =8.132,P ＜ 0.001;social function：t =6.931,P ＜ 0.001.After treatment,combination therapy group compared with drug treatment group：physiological function：t =7.433,P ＜ 0.001;emotional function：t =4.692,P ＜0.001;social function：t =3.297,P ＜ 0.001].Conclusion The clinical efficacy of bronchoscopic interventional cryotherapy in the treatment of bronchial tuberculosis is effective,it can effectively improve the clinical symptoms,improve lesions absorption,shorten symptoms subsided time,reduce the number of treatment,it is helpful to improve the quality of life of patients and worthy of popularization and application.