耐多药肺结核经纤支镜介入治疗的疗效分析

Effect of interventional treatment of MDR-TB by fiberbronchoscope

目的探讨耐多药肺结核(MDR-TB)经纤支镜介入治疗的疗效。方法147例经痰结核菌培养确定的耐多药肺结核患者随机分为2组,均采用3VDZThAK/18VDTh抗痨方案治疗,治疗组强化期同时使用纤支镜介入治疗,然后比较两组的临床疗效。结果疗程结束时,在痰菌阴转(涂片与培养)、病灶吸收总有效率、空洞闭合率方面,治疗组和对照组分别为97.2%和60%,93.1%和48%,98.7%和37.5%,75.7%和46.3%,两组比较均有显著性差异(P<0.01);治疗6个月时,治疗组发热、咳嗽、咳痰、呼吸困难消失率亦均高于对照组(P<0.01)。结论经纤支镜介入治疗联合全身化疗治疗耐多药肺结核,疗效显著优于单纯全身化疗,有促使痰菌阴转、病灶吸收、空洞闭合作用,临床症状消失率好,并且无明显不良反应,并发症少,安全可靠,值得临床推广使用。

Objective To observe the results of inerventional therapy of multi-drug resistant tuberculosis （MDR-TB） by fiberbronchoscope. Methods There 147 MDR-TB patients were randomly divided into 2 groups and treated with regimen of 3VDZThAK/18VDTh,the treatment group at the same time were interventionally treated with bronchoscopy. The results were compared. Results The end results of treatment in sputum conversion （smear and culture）,the total absorption efficiency lesions,the rate of pore closure in the treatment group and control group were 97.2% and 60% ,93.1% and 48%, 98.7% and 37.5%, 75.7% and 46.3% ,respectively , showing significant difference （P〈0.01）; Conclusion Chemotherapy combined with interventional therapy is effective on drug resistant tuberculosis.