・临床论著・电子支气管镜下冷冻治疗支气管结核102例分析刘福升*徐建华蔡秀敏曹艳红(北京老年医院胸外科,北京100095)【摘要】目的探讨电子支气管镜下冷冻治疗支气管结核的疗效。方法2010年2月~2013年7月,对102例支气管结核在常规抗结核化疗基础上,在支气管镜介入下冷冻治疗2~6次,每次间隔2~3周。冷冻术后,用抗结核药物雾化吸入治疗。结果90例溃疡坏死型及肉芽增殖型治疗后,支气管黏膜光滑、管腔通畅;7例支气管腔内遗留少量瘢痕组织,轻度管腔狭窄,不影响通气功能;5例瘢痕型经多次冷冻治疗后,支气管腔狭窄程度无明显改变。治愈率88.2%(90/102),改善率6.8%(7/102),总有效率95.1%(97/102)。结论电子支气管镜下冷冻治疗支气管结核,创伤小,无明显并发症,安全有效。【关键词】电子支气管镜;冷冻;支气管结核中图分类号:R655.3文献标识:A文章编号:1009-6604(2014)10-0881-03doi:10.3969/j.issn.1009-6604.2014.10.004BronchialTuberculosisbyCryotherapyunderElectronicBronchoscope:Analysisof102CasesLiuFusheng,XuJianhua,CaiXiumin,etal.DepartmentofThoracicSurgery,BeijingGeriatricHospital,Beijing100095,ChinaCorrespondingauthor:LiuFusheng,E-mail:liufusheng6178@sohu.com【Abstract】ObjectiveToobservethecryotherapy’sefficacyforbronchialtuberculosisunderelectronicbronchoscope.MethodsAtotalof102casesofbronchialtuberculosisreceivedcryotherapyunderbronchoscopeonthebasisofconventionalantituberculosischemotherapy,rangingfrom2-6timespercasewithanintervalof2-3weeks.Afterfrozensurgery,inhalationtherapywithanti-TBdrugswasused.ResultsFor90caseswithnecrotizingulcerationandgranulationproliferativelesions,patients’bronchialmucosaappearedsmoothandthelumenbecameunimpeded.Asmallamountofscartissuewithmildstenosiswasfoundin7patients’bronchiallumen,buttheventilatoryfunctionwasunaffected.Fivecasesofscar-typepatients’bronchialstenosisshowednosignificantchangeafterrepeatedcryotherapy.Totally88.2%(90/102)ofthe102caseswerecured,6.8%(7/102)improved,andthetotalefficiencywas95.1%(97/102).ConclusionCryotherapyunderelectronicbronchoscopeforbronchialtuberculosisisasafeandeffectivemethodwithoutsignificantcomplications.【KeyWords】Electronicbronchoscope;Cryotherapy;Bronchialtuberculosis气管、支气管结核是由于结核杆菌侵袭气管、支气管黏膜、黏膜下层或进一步破坏肌层及软骨,最终瘢痕愈合,导致气管、支气管狭窄或完全闭塞的一种疾病,是肺结核的一种特殊类型。活动性肺结核患者10%~40%...