经纤维支气管镜导管局部注药治疗耐多药肺结核的临床观察

Bronchfiberscope and Catheter Intervention in Treatment of Multi-drug Resistant Pulmonary Tuberculosis

目的探讨经纤维支气管镜导管局部注药治疗耐多药肺结核(MDR-TB)的疗效.方法将55例耐多药肺结核患者分为治疗组(25例)和对照组(30例),前者在全身化疗的同时于X线透视下经纤维支气管镜导管介入空洞并注入左氧氟沙星、丁胺卡那霉素,后者仅行单纯化疗,比较2组的疗效.结果完成3个月强化期治疗后研究组痰菌阴转率为92%,病灶显效率(显著吸收+吸收)为96%,空洞闭合率为40%,显著高于对照组的46.67%,56.67%和13.33%(P<0.01).结论经纤维支气管镜导管介入空洞内注药局部治疗加全身化疗治疗MDR-TB患者,疗效显著,无明显并发症及毒副反应.

ObjectiveTo evaluate the clinical value of bronchfiberscope and catheter intervention in treatment of multi-drug resistant pulmonary tuberculosis(MDR-TB).MethodsFifty-five patients with MDR-TB were divided into treatment group(25 cases) and control group(30 cases). Twenty-five patients with MDR-TB were treated by injecting levofloxacin and amikacin through bronchfiberscope and catheter in addition to chemotherapy, while thirty patients were treated by chemotherapy only.ResultsAt the end of the third month, the sputum conversion rate was 92%, radiographic improvement rate 96% and cavity closing rate 40% in the study group, all of which were higher than the control group((46.67%),(56.67%) and (13.33%))(P<(0.01)).ConclusionThe efficacy of bronchfiberscope and catheter intervention in addition to chemotherapy is better than chemotherapy only in treatment of MDR-TB, and no complication and obvious adverse reaction were observed.