镜下高频电刀及局部注药联合治疗气管支气管结核

摘要

Objective To explore the effects and safety of treating tracheobronchial tuberculosis by high frequency electrocautery and injecting drugs via bronchofiberscope.Methods One hundred and sixty-one cases of tracheobronchial granulomatic tuberculosis were treated by high frequency electrocautery and injecting isoniazid 0.3 and dexamethasone 5 mg to dilating airway.Observing the curative effect and complications.Results One hundred and fifty-one patients showed remakable improvement in clinical conditions.Collapsed lungs reopened.Airway obstruction dyspnea and relapsing infection were relieved.The effective rate was 93.8％.Six cases of severe cardiac arrhythmia,one mass hemorrhage and one shock happened in treating course.The incidence rate of complication was 2.3％.Conclusion High frequency electrocautery and injecting drugs are valuable in treating tracheobronchial granulomatic tuberculosis and complication is few,but there are some therapy danger and technique difficulty in severe ill.%目的 探讨经纤维支气管镜高频电刀及局部注药联合治疗气管支气管结核的疗效及安全性.方法 对161例气管支气管肉芽增殖型结核,经纤支镜高频电切、电灼肉芽组织,扩大管腔,并于病灶基底部注入异烟肼0.3 g及地塞米松5 mg.观察疗效及并发症.结果 151例患者解除了气道阻塞,症状消失,不张的肺复张,反复感染消除.治疗有效率93.8%.高频电刀治疗中发生严重心律失常(频发室性早搏、室上速、心动过缓)6例、大出血1例、休克1例.并发症发生率2.3%.结论 经纤支镜高频电刀及局部注药联合治疗气管支气管肉芽增殖型结核疗效好,并发症少.治疗气道严重阻塞的重症病例有一定的技术难度和医疗风险.