内科保守治疗与外科手术治疗支气管扩张的临床研究

目的对比分析内科保守治疗与外科手术治疗支气管扩张的疗效。方法60例支气管扩张患者随机分为观察组和对照组，每组各30例，分别采用外科手术治疗和内科保守治疗，对比治疗后的疗效、住院时间、住院费用、症状和体征的缓解时间、血气指标的变化以及外周血ESR、CRP、TNF-a、WBC以及中性白细胞（NEUT）的变化。结果观察组治愈率90．0％显著高于对照组53．4％，而住院时间、症状与体征缓解时间和住院费用均明显小于对照组，差异有统计学意义（均P〈0．05）；治疗后两组血气指标较治疗前均有显著改善（均P〈0．05），两组之间比较，观察组血气指标改善更为显著（均P〈0．05）；治疗后两组ESR、CRP、TNF—a、WBC以及NEUT较治疗前均显著降低（均P〈0．05）；两组之间比较，观察组上述指标值降低更为显著（均P〈0．05）。结论在有手术指征的前提下，外科手术治疗支气管扩张症的疗效要优于内科保守治疗，且其费用较低、住院时间短、临床症状和体征缓解较快，因此具有较好的应用前景。

Clinical research on conservative treatment and surgical treatment for bronchiectasis

Objective To compare the curative effect of conservative treatment and surgical treatment for bronchiectasis. Methods 60 patients with bronchiectasis were randomly divided into observation group and control group,30 cases in each group,they were treated with surgery and medical therapy respectively,the clinical efficacy,length of stay, costs, remission time of symptoms and signs, changes of blood gas index and ESR, CRP,TNF-α, WBC,NEUT of the two groups after treatment were compared. Results The curative rate of observation group was significandy higher than control group, while the length of stay, remission time of symptoms and signs and hospitalization costs were significantly lower than control group, the difference was statistically significant (all P ＜0.05) ;After treatmenit,the blood gas index of both groups improved significantly than before treatment(all P ＜ 0.05), and the blood gas index of observation group improved significantly than the control group (all P ＜ 0. 05); After treatment, ESR, CRP,TNF-α,WBC and NEUT of both groups were significantly decreased compared with those before treatment(all P ＜0. 05); Between the two groups, the index value of the observation group decreased significantly (all P ＜ 0.05).Conclusion Surgical treatment for bronchiectasis was superior to conservative treatment with better curative effect,lower cost, shorter hospital stay and faster relief of symptoms and signs, it had good prospects to be applied.