Integrated interventional bronchoscopy for endobrohchial tuberculosis in 45 children

Abstract

Objective To investigate the efficacy and safety of integrated interventional treatment for children with endobronchial tuberculosis by electronic bronchoscopy. Methods From January of 2011 to August of 2014, 45 cases(31 boys and14 girls)were enrolled, their age ranged from 4 months to 12 years old.On the basis of the conventional anti-tuberculosis treatment in all the patients, electrocoagulation under the bronchoscopy was performed, together with laser, refrigerant or balloon expansion.The tracking observation of curative effect and adverse reaction were observed.Based on the main symptoms of patients after treatment, and the conditions of chest imaging, bronchoscopy, the lesion repair, airway mucosa, lumen patency, therapy efficacy were evaluated.All patients underwent 6-12 months follow-ups. Results Among 45 cases of endobronchial tuberculosis in children, there were 9 cases suffering from ulcers and cheese necrotic changes (20.0%), granulation proliferative changes in 8 cases, accounting for 17.8%, stenosis scar changes in 7 cases(15.5%); 44 mixed cases (97.8%) were observed under the microscope, of which 20 cases had tuberculosis lesions by bronchial biopsy, and of them acid-fast staining was positive in 12 cases(60.8%) confirmed by bronchoscopy combined with anti-tuberculosis treatment, and they received 8 to 13 times of treatment, 32 cases were markedly effective, accounting for 71.1%, 10 cases were effective, accounting for 22.2%; 3 cases lost follow-up, and the total efficiency was 93.3%; all patients had no pneumothorax, pulmonary secondary infection, hemoptysis and other adverse reactions. Conclusions In addition to conventional anti-tuberculosis treatment, local comprehensive interventional treatment under the bronchoscopy can effectively remove cheese-like necrosis and reduce granulation hyperplasia and relieve the airway obstruction, promote the absorption of lesions and atelectasis recovery.The therapy is safe and reliable and worth of clinical application. Key words: Endobronchial tuberculosis; Bronchoscopy; Interventional therapy; Child