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气管支气管结核治疗进展 认领

Progression in treating tracheobronchial tuberculosis
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摘要 目的:对气管支气管结核(tracheobronchial tuberculosis,TBTB)近年治疗的进展作一综述,以期为TBTB系统的治疗提供临床参考。方法:计算机检索中外文数据库,并收集建库至2019年3月公开发表的关于TBTB治疗的相关文献,并加以筛选,分析不同方式治疗TBTB的差异及疗效。结果:TBTB分型包括6种,即炎症浸润型、溃疡坏死型、肉芽增殖型、瘢痕狭窄型、管壁软化型、淋巴结瘘型。在接受传统全身及雾化给药抗结核治疗的基础上,炎症浸润型的治疗以局部给药为主,溃疡坏死型、肉芽增殖型及淋巴结瘘型大多以药物联合冷冻治疗、热消融为主,而瘢痕狭窄型及管壁软化型可选择内科介入或外科手术治疗,建议行多学科讨论后制定具体治疗方案。结论:对于TBTB患者的治疗应严格把握内外科适应证及时机,早期诊断及干预是改善预后的关键措施。 Objective:To summarize the progression in treating tracheobronchial tuberculosis(TBTB),so as to provide clinical references to systematically treat the TBTB.Methods:Literatures about the treatment for TBTB published on the database at home and abroad from the database-established time to March 2019 were collected and screened,and differences and efficacy of different treatment methods for TBTB were analyzed.Results:TBTB contained six subtypes:inflammatory infiltration,ulcerative necrosis,granulation hyperplasia,fibrous stenosis,malacia and lymph node fistula.On the basis of traditional whole body and atomization medication,main treatment for inflammatory infiltration was local medication;main treatment for most of ulcerative necrosis,granulation hyperplasia and lymph node fistula was drug combining cryotheraphy and thermal ablation;treatment for fibrous stenosis and malacia was the internal intervention or surgical treatment.It was suggested to make the specific treatment plan after multidisciplinary discussion.Conclusion:For the treatment of TBTB patients,doctors should strictly catch internal and surgical indications and chances;early diagnosis and intervention are key measures to improve the prognosis.
作者 陈玥龙 戴枥湾 李一诗 郭述良 Chen Yuelong;Dai Liwan;Li Yishi;Guo Shuliang(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Chongqing Medical University)
出处 《重庆医科大学学报》 CAS CSCD 北大核心 2020年第6期714-717,共4页 Journal of Chongqing Medical University
基金 国家“十三五”科技重大专项资助项目(编号:2018ZX10302302003)。
关键词 气管支气管结核 治疗 综述 tracheobronchial tuberculosis therapy review
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