支气管镜介入治疗耐多药肺结核64例分析

Analysis of the treatment of MDR-TB with the intervention of bronchoscope

目的探讨支气管镜介入对耐多药肺结核的治疗价值。方法将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(0.2g)注射液,辅以母牛分枝杆菌菌苗提高全身免疫力治疗耐多药肺结核64例,与单纯全身化疗64例行对照研究。结果痰菌阴转率71.88%,病灶吸收率90.65%,空洞闭合率46.88%均显著高于单纯化疗组59.37%、75%、28.12%。结论经支气管镜局部灌注给药辅以母牛分枝杆菌菌苗治疗耐多药肺结核,可提高患者的细胞免疫功能,促进痰菌阴转及空洞闭合,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 discuss the therapeutic value of MDR - TB with the intervention of bronchoscope. Methods To get the catheter of bronchoscope involved in the corresponding segmental bronchus where the focus of infection places, after complrtely inhaling the excretion of the focus of infection,inject lvofloxacin （0.4 g） and Amikacin （0.2 g） , assisting Myeobacterium boris which can improve the immunity of the whol body to treat the 64 cases MDR - TB,and by contrast with the 64 cases pure ehemo of the whol body. Results The sputum negative conversion rate was 71.88% , absorption rate of focus of infection 90.65% , and cavity closure rate 46.88% , all of which were remarkably higher than that of the pure chemotherapy group. Conclusions The method by bronchoscope＇ s regional perfusion administration,assisting the bacterination of Mycobacterium bovistheamine to treat MDR - TB,can improve the patients＇ cell immune function,promote sputum negative conversion and the closure of cavity. The curative effect is more significant than pure chemo of the whol body, and there is no obvious harm and side effect and complications.