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纤维支气管镜下冷冻术联合药物治疗气管支气管结核的应用价值

Application value of fibro-bronchoscopic cryosurgery combined with medication in the treatment of tracheobronchial tuberculosis.

作者信息

Zhou Yue-Ying, Li Hui-Juan, Wu Kai-Jia, Shi Ji-Chan, Jiang Xian-Gao, He Gui-Qing, Pan Ning, Qiu Chao-Chao, Ning Hong-Ye, Wu Zheng-Xing

机构信息

Departmentof Infectious Diseases, Wenzhou Central Hospital, No. 252 of Baili East Road, Lucheng District, Wenzhou, 325000, China.

ECG Room, Wenzhou Central Hospital, Wenzhou, 325000, China.

出版信息

BMC Surg. 2025 Apr 25;25(1):181. doi: 10.1186/s12893-025-02812-0.

Abstract

OBJECTIVE

To investigate the value of fibro-bronchoscopic cryosurgery combined with medication in the treatment of tracheobronchial tuberculosis (TBTB).

METHODS

This study was designed as a prospective, randomized clinical trial. 96 patients with newly diagnosed TBTB were collected and divided into the study group (n = 48) and the control group (n = 48). Specifically, conventional anti-tuberculosis therapy was given to the control group, with the study group undergoing fibro-bronchoscopic cryosurgery combined with topical administration. Afterward, the post-treatment response rate and adverse reaction indicators were collected for comparison.

RESULTS

After treatment for 6 months, the study group was superior to the control group in terms of clinical efficacy (P = 0.013), negative conversion rate of acid-fast bacilli (P = 0.014), and lesion recovery (P = 0.003); after treatment for 6 months, the study and control groups exhibited no significant differences in the response rate of inflammatory infiltration (P = 1.000) and granulation proliferation (P = 0.061). Additionally, the study group showed a higher response rate of ulcer necrosis (P = 0.041) and cicatricial stenosis (P = 0.029) than the control group, with no significant differences observed in the incidence of adverse reactions between the 2 groups (P = 0.584). Moreover, the clinical efficacy in the study group was higher than that in the control group after treatment for 12 months (P < 0.001).

CONCLUSION

The application of fibro-bronchoscopic cryosurgery combined with topical administration on the basis of conventional anti-TB treatment can improve the clinical efficacy of TBTB patients and shorten the duration of treatment without increasing the incidence of adverse reactions.

摘要

目的

探讨纤维支气管镜冷冻治疗联合药物治疗气管支气管结核(TBTB)的价值。

方法

本研究设计为一项前瞻性随机临床试验。收集96例新诊断的TBTB患者,分为研究组(n = 48)和对照组(n = 48)。具体而言,对照组给予常规抗结核治疗,研究组接受纤维支气管镜冷冻治疗联合局部给药。之后,收集治疗后的反应率和不良反应指标进行比较。

结果

治疗6个月后,研究组在临床疗效(P = 0.013)、抗酸杆菌转阴率(P = 0.014)和病灶恢复方面(P = 0.003)均优于对照组;治疗6个月后,研究组和对照组在炎症浸润反应率(P = 1.000)和肉芽组织增生方面(P = 0.061)无显著差异。此外,研究组溃疡坏死(P = 0.041)和瘢痕狭窄(P = 0.029)的反应率高于对照组,两组不良反应发生率无显著差异(P = 0.584)。而且,治疗12个月后研究组的临床疗效高于对照组(P < 0.001)。

结论

在常规抗结核治疗基础上应用纤维支气管镜冷冻治疗联合局部给药可提高TBTB患者的临床疗效,缩短治疗时间,且不增加不良反应发生率。

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