靖秋生 1胡智敏 1吴鸣镝 1靖娟 1向嵘 1张建爽 1李彩萍2
作者信息
- 1. 430030 武汉市肺科医院武汉市结核病防治所呼吸内镜科
- 2. 华中科技大学同济医学院附属同济医院综合科
- 折叠
摘要
Abstract
Objective To analyze retrospectively influencing factors of rescuing patients with pulmonary tuberculosis complicated with airway obstruction via bronchoscopy in order to provide reference for clinical practice.Methods Eighty-seven patients with pulmonary tuberculosis complicated with airway obstruction were rescued via bronchoscopy in the Department of Respiratory Endoscope of Wuhan Pulmonary Hospital during Jul.2014 to Jun.2016.The data including age,properties and plugging-up points of obstructions,the position when rescuing,time for dredging airway,blood oxygen saturation (SaO2) and heart rate were collected.The factors influenced the effectiveness of rescuing patients with pulmonary tuberculosis complicated with airway obstruction via bronchoscopy were analyzed using SPSS software version 22.0.Chi square test was used for the enumeration data and t test was used for measurement data.P＜0.05 was considered significant difference statistically.Results Of 87 cases rescued via bronchoscopy,77 (88.5％) cases survived and 10 (11.5％) cases died.The obstructions included pus (65.5％ (57/87)) and blood clot (34.5％ (30/87)).The site of obstructions was at trachea plus bilateral bronchus (58.6％,51/87),and at left bronchus plus right bronchus (41.4％,36/87).The difference of pus (50.9％ (29/57)) and blood clot (73.3％(22/30)) obstructed at trachea plus bilateral bronchus was significant statistically (x2 =4.07,P=0.043).The death rate was 2.2％ (1/45) in patients aged less than 60 years old and 21.4％ (9/42) in patients aged be equal or greater than 60 years old.The rate difference was significant statistically (x2=6.10,P=0.013).The rates of death caused by pus and blood clot obstruction at trachea plus bilateral bronchus were 3.5％ (2/57) and 26.7％ (8/30),respectively.The rate difference was significant statistically (x2 =8.21,P=0.004).When survival was compared with death,the difference of average age ((52.92±21.95) and (78.70±18.77) years old),time for dredging airway ((6.25±2.43) min and (9.60±2.37) min),lateral position with normal side down ((11.7 ％,9/77),(50.0 ％,5/10)),average HR intraoperative ((107.38 ± 21.80) times per min,(56.60±18.03)times per min),average SaO2 value intraoperative ((91.34±4.05) ％,(72.70±17.86)％) were significant statistically (t=3.55,P=0.001;t=4.11,P=0.000;x2 =6.99,P=0.008;t=7.05,P=0.000;t=3.29,P=0.009).Conclusion The success rate of bronchoscopy in the treatment of pulmonary tuberculosis complicated with airway obstruction is high.The older age,the site of obstruction at trachea plus bilateral bronchus,blood clot and lateral position with normal side down are main risk factors causing death.关键词
气道阻塞/结核,肺/支气管镜检查/治疗结果/因素分析,统计学Key words
Airway obstruction/Tuberculosis, pulmonary/Bronchoscopy/Treatment outcome/Factor analysis, statistics
