第12卷第1期2006年1月中国内镜杂志ChinaJournalofEndoscopyVd12~“Jan.2006文章编号:1007—1989(2006)01—002404经纤维支气管镜KTP激光在支气管结核治疗中的应用价值探讨李彩萍,,靖秋生。,刘晓晴(1.华中科技大学同济医学院附属同济医院综合科,湖北武汉4300302斌汉市结核病防治所纤维支气管镜室,湖北武汉430030)·论著·摘要:目的探讨钛氧磷酸钾(potassiunltitaJWlphosphate,KTP)激光在支气管结核治疗中的应用价值。方法36例支气管结核病例使用KTP激光汽化或炭化、凝固支气管内干酪样坏死物和部分肉芽组织,疏通支气管,同时行空身正规抗结核治疗,局部点洒畀烟肼i00rn窖+T胺卡那霉素200rag+地塞米松2mg。KqP激光治疗2-5周,每周1次,每次治疗时间I、2sx10qns,间歇2、3s.治疗电流10A+,导光纤雏04mm或0.6mm,脉搏血氧计监视惠者术前、术中、术后的心率和血氧饱和度的变化。选取同时期病况基本相同的36倒病例作为对照蛆,除不接受KTP激光治疗外,其他治疗方法相同,包括每周1次病变管腔内的冲洗、抽吸、钳夹、注药。8用和6个月后纤支镜复查稿变支气管的管腔、管壁的变化,同时复查胸片了解肺不张的完全恢复与否。结果8周后纤支镜复查。管胜恢复率为86.1%(31/36),肺不张恢复率为8lo%(17/21),阻塞性感染恢复率为818%(9/11),并发症发生率为83%(3/36),与对照组比较差异均有显著性。而术前、术中厦术后的血氧饱和度和心率则无明显变化。6个月后支气管狭窄和肺不张发生率以_及其他后遗症均明显低于对照组,结论KTP激光治疗支气管结核疗效较好,对正常纽织损伤小,创面恢复快,并发症少,可作为治疗置气管结核的有效手段之一.值得推广。关键词:KTP激光;支气管;结核;纤维支气管镜中图分类号:R4542文献标识码:AToprobeintovaluesoftherapywithpotassiumtitanylphosphate(KTP)laserinendobronchialtuberculosisbybranchofiberoscopeLICat—pin91.JINGQiu—shen92.IJUXiao—qln91(,GeneralDeportmentofTo”舒‘Hospital,TonalCollege,HuazhongUniversityofScwnceandTechnolog);Wuhan,Hubei430030,PRChina,.2.WuhanTuberculosisControlCenter,Wuhan,Hubei430030,PRChina)Abstract:【0bjective】TopmbeintothevaluesoftherapywithPotassiumTflanylPhosphate(KTP)laserintheendol>ronchialtuberculosisbybranch06bcH瑚。肛【Methods】Forthetherapygroup,K‘FPlaservaporized,coagulat·edandcarbonizedCBSCOILSnecroticmassandsegmentalacestomaintheendohronchus.dredgedendobranchiallil一menAllpatientsreceivedregulargeneralantituhercuh)sistherapy.Isoniazid100mg+mnikaein200mg+Dexam—ethasone2mgwcreinsufflatedLothefoCU$bet:areandafteroperation.KTPl}tsertherapyperiodswere2to5weeks、once、veekly,therapytimeswere1to2secondsLimes10to20.andintermittenttimesweFe2to3scconds,therapy'C11I_1entwNB10A+Thediameteroflightguidefiberis0.4mmor0.6[timOhservedtilechangesofSaO!andIfRbeNre,duringandafteroperationAftcifinishedKTPIJterapv,obsmwedthechangesoftheendobmnehiaIhlmellandwallbyweeklyexaminationwithbranehofihetoseope7I'oknowthcchestXraychangesofallpatientsThecontrolgmupundenventthesametherapymethc.dsexceptKTPlaser.【Results】Wereexamined36casesoftherapygroup收稿日期-2005—03—27万方数据万方数据第1期李彩萍,等:经纤维支气管镜KTP激光在支气管结核治疗中的应用价值探讨bybranchofibemscopeafter8眦ks,rehabiUitativeratesofendobronchiaI1nmeHwcrc861%f31/36),resunl面Veratesofateleetasls81.0%(17/21),curetIatesofobstmchvcinfection818%(9/11),complications83%(3/36)Thereweresignificantdifferencescomparingtherapygroupwithcontml19"oupChangesofSa02andHRbefore.duringandafteroperationwereinapparentAllsmSsofcomplicatonofdlerapygroupWel'elesserdistinctlythancontrolgroupafter6months【Conclusions】K耶lasortreatingendobmnchialtuberculosis1S...