Zhao Yidi, Zhang Tongqiang, Yang Nan, Xu Yongsheng, Guo Wei
Children's Clinical College of Tianjin Medical University, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.
Department of Pulmonology, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.
Front Pediatr. 2022 Oct 10;10:984738. doi: 10.3389/fped.2022.984738. eCollection 2022.
This study aimed to investigate the efficacy and safety of CO cryotherapy for lymph node fistula tracheobronchial tuberculosis (TBTB) in infants.
A retrospective analysis was undertaken on seven patients with lymph node fistula tracheobronchial tuberculosis who underwent fiberoptic bronchoscopy (FB) interventional therapy in the respiratory department of Tianjin Children's Hospital from July 2012 to July 2020. The efficacy, safety, and prognosis of CO cryotherapy intervention for the treatment of lymph node fistula TBTB in infants were summarized and analyzed.
Seven patients with lymph node fistula TBTB were included in this study. Their ages ranged from 6-13 months. The course of the disease from onset to TBTB ranged from 20 to 70 days. The pathological diagnoses of seven cases by FB combined with tissue biopsy were lymph node fistula TBTB, of which 28.57% (two cases) were in the early stage of rupture and 71.43% (five cases) were in the rupture stage. All patients were treated with CO cryotherapy combined with foreign body forceps and local injection drugs based on systemic antituberculosis chemotherapy. Two patients were treated once with CO cryotherapy, and five were treated three times. According to the comparison of the clinical symptoms, imaging results, and endoscopic presentations before and after the intervention, six patients achieved clinical cure, and one achieved clinical improvement. No severe intraoperative or postoperative complications were observed. The clinical symptoms, endoscopic findings, radiological manifestations, and quality of life of all patients showed marked improvement. No recurrence occurred after 3-6 months of follow-up with FB.
CO cryotherapy can improve the treatment effect of lymph node fistula in infants with TBTB and reduce the incidence of complications. This treatment is safe and reliable in infants.
本研究旨在探讨CO冷冻疗法治疗婴幼儿淋巴结瘘型气管支气管结核（TBTB）的疗效及安全性。
对2012年7月至2020年7月在天津市儿童医院呼吸科接受纤维支气管镜（FB）介入治疗的7例淋巴结瘘型气管支气管结核患者进行回顾性分析。总结并分析CO冷冻疗法干预治疗婴幼儿淋巴结瘘型TBTB的疗效、安全性及预后。
本研究纳入7例淋巴结瘘型TBTB患者。年龄6 - 13个月。病程从发病至TBTB为20至70天。7例经FB联合组织活检的病理诊断均为淋巴结瘘型TBTB，其中28.57%（2例）处于破裂早期，71.43%（5例）处于破裂期。所有患者在全身抗结核化疗基础上，采用CO冷冻疗法联合异物钳及局部注射药物治疗。2例患者接受CO冷冻疗法1次，5例接受3次。根据干预前后临床症状、影像学结果及内镜表现比较，6例患者临床治愈，1例临床好转。未观察到严重的术中或术后并发症。所有患者的临床症状、内镜检查结果、影像学表现及生活质量均有明显改善。FB随访3 - 6个月无复发。
CO冷冻疗法可提高婴幼儿TBTB淋巴结瘘的治疗效果，降低并发症发生率。该治疗方法在婴幼儿中安全可靠。
