支气管镜介入冷冻联合3HRZE/9HR方案治疗淋巴结瘘型气管支气管结核的疗效观察

Efficacy of bronchoscopic interventional freezing combined with 3HRZE/9HR regimen in the treatment of lymph node fistula type tracheobronchial tuberculosis

摘要:

目的 探讨支气管镜介入冷冻联合3HRZE/9HR方案治疗淋巴结瘘型气管支气管结核的临床疗效与安全性。方法 前瞻性选取2020年10月—2024年7月武威市人民医院收治的120例淋巴结瘘型气管支气管结核患者，随机分为观察组和对照组，各60例。对照组患者接受3HRZE/9HR方案治疗；观察组患者接受支气管镜介入冷冻联合3HRZE/9HR方案治疗。比较两组治疗前后临床疗效，呼吸困难指数分级、肺功能指标［第1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、最大呼气流量（PEF）］、血气分析［动脉血氧分压（PaO₂）、动脉血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）］及不良反应发生情况。结果 观察组总有效率高于对照组（P <0.05）；治疗后观察组呼吸困难指数分级水平低于对照组（P <0.05）；治疗后观察组FEV₁、FVC、PEF水平均高于对照组，且观察组治疗前后FEV₁、FVC、PEF水平的差值均大于对照组（P <0.05）；治疗后观察组PaO₂、SaO₂水平均高于对照组，PaCO₂水平低于对照组，且观察组治疗前后PaO₂、SaO₂、PaCO₂水平的差值均大于对照组（P <0.05）；观察组与对照组不良反应总发生率的比较，差异无统计学意义（P >0.05）。结论 支气管镜介入冷冻联合3HRZE/9HR方案治疗淋巴结瘘型气管支气管结核能有效提升治疗效果，优化患者的临床指标与症状表现，推动患者康复进程，且此联合治疗方案具有良好的安全性，具备临床推广应用价值。?

Abstract:

Objective To investigate the clinical efficacy and safety of bronchoscopic interventional freezing combined with 3HRZE/9HR in the treatment of lymph node fistula-type tracheobronchial tuberculosis.Methods Clinical data of 120 patients with lymph node fistula-type tracheobronchial tuberculosis who were diagnosed and treated in our hospital from October 2020 to July 2024 were collected prospectively. They were randomly divided into an observation group (n = 60) and a control group (n = 60). In the control group, patients were treated with 3HRZE/9HR; in the observation group, patients were treated with bronchoscopic interventional freezing combined with 3HRZE/9HR. Compare the clinical efficacy, dyspnea index grading, lung function indexes (FEV₁, FVC, and PEF), blood gas analysis (PaO₂, SaO₂ and PaCO₂), and the incidence of adverse reactions before and after the treatment in the observation Group and the control group.Results The total effective rate in the observation group was higher than that in the control group (P < 0.05). After treatment, the grading level of the dyspnea index in the observation group was lower than that in the control group (P < 0.05). After treatment, the levels of FEV₁, FVC, and PEF in the observation group were higher than those in the control group, and the differences in FEV₁, FVC, and PEF levels before and after treatment in the observation group were greater than those in the control group (P < 0.05). After treatment, the levels of PaO₂ and SaO₂ in the observation group were higher than those in the control group, while the level of PaCO₂ was lower than that in the control group, and the differences in PaO₂, SaO₂, and PaCO₂ levels before and after treatment in the observation group were greater than those in the control group (P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group (P > 0.05).Conclusion Bronchoscopic interventional freezing combined with 3HRZE/9HR in the treatment of lymph node fistula tracheobronchial tuberculosis can effectively improve the therapeutic effect, optimize the patients' clinical indicators and symptoms, and promote the recovery process of the patients, with favorable safety, which is of great value to be promoted and applied in the clinic.