团 体 标 准 肺结核空洞合并曲霉球支气管镜介入 治疗规范 Specificationofbronchoscopicinterventiontherapyforcavitary tuberculosiswithaspergillomaICS11.020 CCSC05 T/CHATA036—2024 2024-06-11 发布 2024-06-11 实施 中国防痨协会发布 全国团体标准信息平台 全国团体标准信息平台 T/CHATA036—2024 1目次 前言....................................................................................................................................................................1 1范围..............................................................................1 2规范性引用文件....................................................................1 3术语和定义.......................................................................11 4设施与设备........................................................................2 5肺结核空洞合并曲霉球的诊断........................................................2 5.1诊断原则......................................................................2 5.2支气管镜检查..................................................................2 6适应症及禁忌症....................................................................2 7介入治疗时机选择..................................................................3 8介入治疗频次确定...................................................................3 9术前准备..........................................................................3 9.1患者知情同意..................................................................3 9.2患者准备......................................................................3 9.3医护准备......................................................................4 10镇静与麻醉.......................................................................4 10.1麻醉术式的选择原则...........................................................4 10.2表面麻醉.....................................................................4 10.3轻、中度镇静.................................................................5 10.4深度镇静或静脉麻醉............................................................5 11体位选择.........................................................................5 12插入途径.........................................................................5 13镜下直视观察.....................................................................5 14清除治疗.........................................................................5 14.1对支气管镜可顺利进入空洞者的清除治疗.........................................5 14.2支气管镜无法进入空洞者的清除治疗.............................................6 15常见并发症处理...................................................................6 15.1出血性并发症..................................................................6 15.2麻醉药物相关并发症...........................................................6 15.3低氧血症.....................................................................7 15.4心律失常.....................................................................7 15.5气胸.........................................................................8 全国团体标准信息平台 T/CHATA036—2024 15.6感染和发热...................................................................8 15.7特殊患者的并发症.............................................................8 16术后处理.........................................................................8 16.1生命体征观察.................................................................8 16.2症状询问及巡视...............................................................9 17治疗效果评估和术后随访...........................................................9 17.1治疗评估.....................................................................9 17.2后续治疗方案.................................................................9 17.3术后随访.....................................................................9 附录A（资料性）肺结核空洞合并曲霉球支气管镜介入治疗流程...........................10 附录B（资料性）肺结核空洞合并曲霉球支气管镜介入具体操作流程........................11 附录C（规范性）特殊患者的术前准备.................................................12 附录D（资料性）治疗疗效评估标准...................................................13 参考文献...........................................................................14 全国团体标准信息平台