经纤维支气管镜介入治疗耐多药肺结核疗效观察

Observation on the effects of injecting meddicine through bronchoscope to treat MDR-TB

目的探讨经支气管镜导管介入病灶内注药配合全身化疗治疗耐多药肺结核的疗效。方法将确诊的136例耐多药肺结核患者随机分为治疗组(64例)和对照组(72例),均采用3VHZALP/9VHZL化疗方案治疗,治疗组经纤维支气管镜导管介入病灶内注入左氧氟沙星、丁胺卡那霉素,疗程6个月。结果治疗3个月、6个月时,治疗组痰菌阴转率为71.9%和81.3%均高于对照组的47.2%和55.6%,差异有统计学意义(P<0.05)。治疗6个月时,治疗组X线胸片空洞闭合率、病灶缩小率均较对照组有所改善,差异有统计学意义(P<0.01)。结论经纤维支气管镜导管介入病灶内注药加化疗治疗耐多药肺结核,疗效显著优于单纯化疗,且无明显不良反应,并发症少。

Objective To investigate the effects of of injecting meddicine through bronchoscope accompanying the general therapy to treat MDR-TB. Methods 136 cases patients of MDR-TB were randomly divided into two groups：the treatment group and the control group. Both groups received chemotheropy of 3VHZALP/9VHZL, and the former were injected V and A through bronchoscop. Results At the end of six months of treatment, the sputum negative conversion rates （81.2% ）, the cavity closing and shrinking rates（81.2% ） of the treatment group were remarkable higher than ones of the control group （ 55.6% vs 47.2%, P 〈 0.05 ）. At the six months of treament, the treatment group X-ray carity closure rates, reduce the rate of lesions than those in the lontrol group improved significantly （P 〈 0.01 ）. Conclusion The effect of treating MDR-TB by injecting medicine through bronchoscope accompanying the general therapy is better than one of the simple chemotheropy, and has less side-effects complications.