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目的初步探讨苦参素注射液在治疗结核瘢痕增生性气管狭窄中的局部应用。方法根据支气管结核患者瘢痕增生性狭窄的部位、长度、横截面积、远端气管功能状况,选择不同浓度苦参素注射液,在无痛气管镜下采取序贯多种介入联合治疗方法之后,采用一次性内镜喷洒管喷洒病变部位,视情形每周给药一次,累计2~4次,总体随访时间共3个月。结果例1、例2术后呼吸困难指数均较术前降低、肺功能FEV1.0%改善明显、6MWT明显增加、狭窄管腔直径明显增加,例3经4周次镜下治疗后发现病灶所在管腔远端已无功能,最终放弃治疗。结论本研究初步提示在良性瘢痕增生性气管狭窄介入治疗后或维持治疗中,苦参素注射液在气管内局部应用可能具有安全性较高,疗效较好,且操作简便等优点,值得进一步探讨研究。
Objective To investigate the topical application of oxymatrine injection in the treatment of hypertrophic tracheal stenosis with tuberculosis. Methods According to the site, length, cross-sectional area and distal tracheal function of patients with hypertrophic scar in patients with bronchial tuberculosis, different concentrations of oxymatrine injection were selected and followed by multiple sequential interventions under painless bronchoscopy. Disposable endoscopic spray tube spraying the lesion site, depending on the circumstances once a week, a total of 2 to 4 times, the overall follow-up time of 3 months. Results In cases 1 and 2, the index of dyspnea after operation was lower than that before operation, the pulmonary function FEV1.0% was significantly improved, 6MWT was significantly increased, and stenosis lumen diameter was significantly increased. Case 3 was found after 4 weeks of microscopic treatment of lesion lumen Far has no function, and eventually give up treatment. Conclusions This study suggests that the local application of oxymatrine injection in the trachea after benign scar hypertropic tracheal stenosis may have the advantages of higher safety, better curative effect and simple operation in the treatment of benign scar hypertropic tracheal stenosis, which is worth further exploration the study.