超声雾化吸入联合全身化疗治疗耐多药肺结核

The study of the effect of the treatment of multi-drug resistent pulmonary tuberculosis with with steam inhalations and chemotherapy

目的:探讨超声雾化吸入联合全身化疗治疗耐多药肺结核(MDR)的临床疗效;方法将87例耐多药肺结核患者随机分为治疗组和对照组,所有患者均采用3ADTVEZ/15DTVE抗结核治疗,治疗组病人前二个月加用异烟肼0.2及左氧氟沙星0.2超声雾化吸入,每天一次,然后比较两组在痰菌阴转率、病灶显效率、空洞闭合率等方面的差异;结果治疗2个月、18个月时两组患者的痰菌阴转率之间存在显著性差异(p<0.05);治疗结束时两组患者病灶显著吸收、吸收率之间亦有显著性临床差异(p<0.05),治疗结束时空洞闭合、缩小率之间同样有显著性差异(p<0.05);结论超声雾化吸入联合全身化疗治疗MDR可促使痰菌阴转、空洞净化、闭合,且没有明显毒副作用。该方法经济、方便、有效,易于各级各类医院开展。

objective To evaluate the efficacy of the treatment of multi-drugresistent pulmonary tuberculosis with with steam inhalations and chemotherapy. Method 87cases of multi-drug resistant pulmonary tuberculosis were randomly divided into the treatment group and the control group. All patients in both groups received the 3ADTVEZ/15DTVE treatment, while the patients of the treatment group accepted steam inhalations, which involved adding isoniazid and Levofloxacln, once a day in the first two months, then Comparisons were made between the two groups in the sputum tubercle bacillus conversion rate, radiographic improvement rate , cavity dosing rate, clinical symptom improvement rate. Results By the end of 2 months and 18 months , there were significant difference in the sputum tubercle bacillus conversion rate between the two groups （P 〈 0.05）. By the end of 18 months , there were significant difference in radiographic improvement rate and cavity closing rate between the two groups （P 〈0.05）. Conclusion The treatment of multi-drugresistent pulmonary tuberculosis with with steam inhalations and chemotherapy provided the significant effect on cleaning, closing of the cavity as well as turning sputum negative. It is worthwhile that the clinical application should be approached extensively.