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Chinese Journal of Diagnostics(Electronic Edition) ›› 2021, Vol. 09 ›› Issue (03): 181-186. doi: 10.3877/cma.j.issn.2095-655X.2021.03.010

• Clinical Study • Previous Articles     Next Articles

Application value of transbronchoscopic high-frequency electrosurgical thermal ablation combined with cryotherapy in the treatment of tracheobronchial tuberculosis

Binying Ji1, Ying Zhang1, Xiaorui Wang1, Yanju Su1, Yang Jiang1, Zhe Liu1, Hong Lin1, Chunhui Guo1,()   

  1. 1. Department of Tuberculosis, Harbin Chest Hospital, Harbin 150056, China
  • Received:2020-11-20 Online:2021-08-26 Published:2021-09-03
  • Contact: Chunhui Guo

Abstract:

Objective

To investigate the efficacy and safety of transbronchoscopic high-frequency electrosurgical thermal ablation combined with cryotherapy in the treatment of tracheobronchial tuberculosis (TBTB).

Methods

From 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.

Results

In 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.

Conclusion

Different 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.

Key words: Bronchi, Tuberculosis, Thermal ablation, Cryosurgery, High frequency electrotome

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