经纤维支气管镜局部灌注给药治疗耐多药肺结核

Treatment of multi-drug resistance pulmonary tuberculosis by regional perfusion via bronchofiberscope

目的探讨经纤维支气管镜局部灌注给药对耐多药肺结核患者的治疗价值。方法将纤维支气管镜导管介入至相应的病灶所在段支气管,吸净病灶分泌物后,注入左氧氟沙星(0.4g)和丁胺卡那(0.4g)注射液,辅以全身化疗治疗耐多药肺结核42例,与单纯全身化疗37例进行对照研究。结果经纤维支气管镜介入局部灌注给药组,疗程满9个月时痰菌阴转率为92.9%,病灶吸收有效率为90.5%,均高于单纯全身化疗组的62.2%、59.5%(P<0.01)。结论经纤维支气管镜局部灌注给药辅以全身化疗治疗耐多药肺结核疗效显著优于单纯全身化疗,且未见并发症和明显毒副反应。

Objective To evaluate the clinical value bronehofiberscope and per＇fusion in the treatment of multi - drug resistant pulmonary tuberculosis （MDR - TB）. Methods Forty- two cases were treated by injecting amikacin （0.4 g）, ofloxacin （0.4 g）, alter cleaning up exudation through bronchofiberscope and catheter intervention combined with chemotherapy therapy, while 37 controls were treated by chemotherapy only. Resutls By the end of 9 months, the sputum tuhercle bacillus conversion rate, radiographical improvement rate were 92.9% and 90.5% respectively in the treated groups, while all these indications were higher than these of control group 62.2% and 59.5% （ P 〈 0. 01 ）. Conclusions Bronchofiberscope and perfusion combined with chemotherapy is more effective than simple chemotherapy in the treatment of MDR- TB, no complication and obvious adverse reaction are observed.