镜下介入治疗对结核病合并气道狭窄的远期疗效

Long-term efficacy of bronchoscopic interventional therapy in treatment of tuberculosis patients complicated with tracheobronchial stenosis

  • 摘要: 目的 探讨气管镜下介入治疗对结核病合并气道狭窄患者临床预后的影响。方法 回顾性分析2019年1月-2022年7月分别于首都医科大学附属北京胸科医院和天津市海河医院接受非介入治疗和介入治疗的结核病合并气道狭窄患者共179例的临床资料。采用倾向性评分匹配平衡介入组与非介入组的基线差异,最终纳入75例患者进行分析,比较两组患者的治疗结局。结果 倾向性评分匹配前,介入组总体症状好转率高于非介入组(71.53% vs. 54.76%,P=0.042),病情恶化率差异无统计学意义(P=0.553); 倾向性评分匹配后,介入组与非介入组症状好转率差异无统计学意义(74.51% vs. 58.33%,P=0.156),病情恶化率差异亦无统计学意义(P=0.653)。结论 在结核病合并气道狭窄患者中,介入治疗可在一定程度上改善患者症状,但在倾向性评分匹配平衡基线差异后,其对1年症状好转率的影响未达到统计学意义。患者症状改善可能受多种因素共同影响,仍需进一步开展大样本前瞻性研究加以验证。

     

    Abstract: OBJECTIVE To observe the effect of bronchoscopic interventional therapy on clinical treatment outcomes of the tuberculosis patients complicated with tracheobronchial stenosis. METHODS A total of 179 tuberculosis patients complicated with tracheobronchial stenosis who received non-interventional therapy and interventional therapy in Beijing Chest Hospital, Capital Medical University and Tianjin Haihe Hospital, respectively, from Jan. 2019 to Jul. 2022 were enrolled in the study, and the clinical data of the patients were retrospectively analyzed. The baseline differences between the interventional group and the non-interventional group were balanced by means of propensity score matching. Totally 75 patients were finally included. The treatment outcomes were compared between the two groups of patients. RESULTS The overall improvement rate of symptoms of the interventional group was 71.53%, higher than 54.76% of the non-interventional group (P=0.042); there was no significant difference in the exacerbation rate between the two groups (P=0.553). There was no significant difference in the improvement rate of symptoms between the interventional group and the non-interventional group after the propensity score matching(74.51% vs. 58.33%,P=0.156), and there was also no significant difference in the exacerbation rate(P=0.653). CONCLUSIONS Among the tuberculosis patients complicated with tracheobronchial stenosis, the interventional therapy partially alleviated the symptoms. However, its impact on the 1-year symptom improvement fails to achieve statistical significance after the baseline characteristics are balanced by the propensity score matching. Given that the improvement of symptoms may be affected by multiple factors, prospective research on large size of samples is still necessary for further validation.

     

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