Application value of transbronchoscopic high-frequency electrosurgical thermal ablation combined with cryotherapy in the treatment of tracheobronchial tuberculosis
Ji Binying, Zhang Ying, Wang Xiaorui, Su Yanju, Jiang Yang, Liu Zhe, Lin Hong, Guo Chunhui
Department of Tuberculosis, Harbin Chest Hospital, Harbin 150056, China
Abstract：ObjectiveTo investigate the efficacy and safety of transbronchoscopic high-frequency electrosurgical thermal ablation combined with cryotherapy in the treatment of tracheobronchial tuberculosis (TBTB). MethodsFrom August 2018 to September 2019, 79 patients with TBTB hospitalized in Tuberculosis Department of Harbin Chest Hospital were retrospectively analyzed. The patients who were treated by high-frequency electrosurgical thermal ablation combined with cryotherapy by bronchoscopy and injection of antituberculosis drugs were classified into observation group (n=31), and the patients who were treated by cryotherapy and injection of antituberculosis drugs by bronchoscopy were classified into control group (n=48). After 2 months of treatment, the treatment frequency, negative sputum conversion, bronchoscopy performance, imaging performance and clinical symptoms of the two groups of patients were compared and analyzed. ResultsIn the observation group, 31 patients received 77 times of bronchoscopic cryotherapy combined with high-frequency electrosurgical thermal ablation, with an average of (2.48±1.21) times per patient. Patients in the control group received bronchoscopic cryotherapy for 178 times, with an average of (3.71±1.24) times per case. The average number of interventional therapy in the observation group was smaller than that in the control group, and the difference was statistically significant (t=4.34, P＜0.05). The sputum negative rate in the observation group was 86.36% (19/22), which was higher than that in the control group ［60.00%(21/35)］, and the difference was statistically significant (χ2=4.49, P＜0.05). In the observation group, the airway obstructions of patients were relieved, symptoms disappeared and the pulmonary lesions improved significantly. After 2 months of treatment, the total effective rates of the two groups compared in bronchoscopy, imaging and clinical efficacy were ［93.55%(29/31), 93.75%(45/48), 90.32%(28/31), 87.50%(42/48), 93.55%(29/31), 89.58%(43/48)］, with no significant differences （Z=-0.84, -0.86, -0.47, all P＞0.05）. No serious adverse reactions occurred in the two groups of patients. ConclusionDifferent types of TBTB treated by bronchoscopy of thermal ablation can achieve satisfactory results, and the combination of thermal ablation and cryotherapy by bronchoscopy has more advantages.
纪滨英 张莹 王晓瑞 苏衍举 姜杨 刘哲 林红 郭春辉. 经支气管镜高频电刀热消融联合冷冻术在气管支气管结核治疗中的应用价值[J]. 中华诊断学电子杂志, 2021, 9(3): 181-186.
Ji Binying, Zhang Ying, Wang Xiaorui, Su Yanju, Jiang Yang, Liu Zhe, Lin Hong, Guo Chunhui. Application value of transbronchoscopic high-frequency electrosurgical thermal ablation combined with cryotherapy in the treatment of tracheobronchial tuberculosis. zhzdx, 2021, 9(3): 181-186.
